Topographic differences in amniotic fluid concentrations of prostanoids in women in spontaneous labor at term

Romero, Roberto; González, Rogelio; Baumann, P.; Behnke, Ernesto; Rittenhouse, Linda; Barberio, D.; Cotton, David B.; Mitchell, Murray D.

doi:10.1016/0952-3278(94)90154-6

Cited by 47 publications

(23 citation statements)

References 8 publications

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“…Our data clearly showed that there was a significant decrease in PGHS2 mRNA concentration from the cervix to the fundus suggesting that the formation of a PG gradient throughout the uterus is a physiological event in late gestation and at labor (Romero et al 1994). This increased local PG production activity may be critical for pregnancyassociated lower uterine segment elongation, cervical softening and effacement in primate labor.…”

Section: Discussionmentioning

confidence: 71%

Characterization of the concentration gradient of prostaglandin H synthase 2 mRNA throughout the pregnant baboon uterus

Wen

Smith

Rose

et al. 2004

Journal of Endocrinology

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The present study was designed to determine the effect of the spatial gradient from the cervix to the uterine fundus on the control of local prostaglandin H synthase (PGHS) 2 mRNA expression. We performed total cesarean hysterectomies during the last trimester in 12 pregnant baboons, 7 not in labor and 5 in labor, and examined PGHS2 mRNA expression throughout the uterus. PGHS2 mRNA abundance was quantified by in situ hybridization and northern blot analysis in the uterine fundus, lower uterine segment and the different segments of the cervix. Quantitative northern blot and in situ analysis demonstrated a gradient of PGHS2 mRNA expression, with the highest levels at the level of the lower portion of the cervix and decreased expression through the mid-and upper portion of the cervix and lower uterine segment; the lowest levels of expression were seen in the uterine fundus.Moreover, cellular localization of PGHS2 mRNA and protein demonstrated high levels of expression in the cervical glandular epithelial cells with only occasional staining of smooth muscle cells in pregnant baboons. Decreased PGHS2 mRNA concentration gradient from the cervical external os to the fundus suggests that prostaglandin (PG) production in the uterus and cervix strongly depends on anatomical relations. This increased local PG production activity may be critical to pregnancyassociated lower uterine segment elongation, cervical softening and effacement in primate labor. These data provide a compelling biological basis for the use of PGHS2 inhibitors in the prophylaxis of preterm birth and cervical incompetence.

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Section: Discussionmentioning

confidence: 71%

Characterization of the concentration gradient of prostaglandin H synthase 2 mRNA throughout the pregnant baboon uterus

Wen

Smith

Rose

et al. 2004

Journal of Endocrinology

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“…Therefore, the population did not represent physiology. Moreover, most of the earlier studies have included AF obtained transvaginally [7,13,[20][21][22], in which PG concentrations are significantly higher than those in AF retrieved transabdominally [23]. The main advantage of the present study over prior ones is that our data were obtained from pregnancies in normal physiologic condition (except for four cases of prolonged second stage of labor).…”

Section: Strengths and Weakness Of This Studymentioning

confidence: 77%

Amniotic fluid prostaglandin concentrations increase before the onset of spontaneous labor at term

Lee

Romero

Park

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

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Objectives. The role of prostaglandins (PGs) in the onset of human parturition has been controversial. Specifically, some investigators have proposed that PGs are the consequence rather than the cause of labor. An important question is whether or not amniotic fluid (AF) PG concentrations increase before the onset of labor in humans. Methods. The concentrations of PGs were determined in AF obtained from 167 singleton pregnant women with intact membranes. Patients were divided into four groups: (1) preterm not in labor (gestational age 15-36 weeks, n ¼ 65); (2) term not in labor (n ¼ 68); (3) spontaneous labor at term with cervical dilatation 54 cm (n ¼ 25); (4) spontaneous labor at term with cervical dilatation 4 cm (n ¼ 9). AF was obtained by transabdominal amniocentesis or collected at the time of cesarean delivery. All patients met the following criteria: (1) normal pregnancy outcome; (2) clear AF; (3) no significant medical or obstetric complications such as diabetes mellitus, preeclampsia, preterm birth, fetal growth restriction, or major congenital malformations; and (4) no significant neonatal complications. The concentrations of PGE2 and PGF2a in AF were determined by enzyme-linked immunosorbent assay (ELISA). Non-parametric analysis was performed. Results. (1) AF PG concentrations remained unchanged with advancing gestation until 36 weeks of gestation; (2) however, an abrupt increase in AF PG concentrations was observed before the onset of labor at term; (3) among cases without labor at term, the median AF PGF2a concentration increased with advancing gestation; (4) the presence of labor and the degree of cervical dilatation were significantly associated with a higher concentration of PGF2a.Conclusions. An abrupt increase in AF PG concentrations (25-fold for PGF2a) occurs before the onset of spontaneous labor at term in humans; these observations suggest that PGs increase prior to the onset of labor and contradict the claim that an increase in PG concentrations is the consequence of labor.

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“…Moreover, because of increasing recognition that the different segments of the uterus (fundus and lower uterine segment) may play different roles in the process of parturition 6,18 , possible intrapartum differences in immunoreactive MCP-1 concentrations between the upper and lower amniotic fluid compartments were also assessed.…”

Section: Introductionmentioning

confidence: 99%

Amniotic fluid levels of immunoreactive monocyte chemotactic protein-1 increase during term parturition

Esplin

Romero

Chaiworapongsa

et al. 2003

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective: Parturition is characterized by an influx of inflammatory cells into gestational tissues, a phenomenon conducive to increased myometrial contractility, cervical ripening and decidual/ membrane activation. Monocyte chemotactic protein-1 (MCP-1), a potent chemoattractant and activator of monocytes/macrophages, is expressed in gestational tissues and, thus, may participate in the final common pathway of labor. This study was undertaken to determine whether the amniotic fluid concentrations of immunoreactive MCP-1 are altered with gestational age or spontaneous labor at term with and without prelabor rupture of the gestational membranes. We also sought to identify intrapartum differences in the concentrations of immunoreactive MCP-1 between the upper and lower amniotic fluid compartments. Methods: A cross-sectional study was conducted to assess the concentrations of immunoreactive MCP-1 in amniotic fluid. Amniotic fluid samples were obtained from 225 women as follows:(1) women undergoing mid-trimester (14-18 weeks of gestation) amniocentesis for genetic indications, whose pregnancy outcome was normal (n = 84); (2) women in labor (n = 52) and not in labor (n = 31) at term, with intact gestational membranes; (3) women with rupture of the gestational membranes in labor (n = 18) and not in labor (n = 26), at term; and (4) women in labor at term for whom paired amniotic fluid samples were obtained through transvaginal and transabdominal amniocenteses (n = 14). Immunoreactive MCP-1 was assessed with a specific and sensitive immunoassay that had been validated for amniotic fluid. Non-parametric statistics were used for analysis. Results: Immunoreactive MCP-1 was detected in all amniotic fluid samples. Spontaneous human parturition was associated with a significant increase in the amniotic fluid concentrations of immunoreactive MCP-1 (not in labor: median 595 pg/ml, range 183-3579 pg/ml vs. in labor: median 862 pg/ml, range 183-9609 pg/ml; p = 0.01). The median amniotic fluid concentrations of immunoreactive MCP-1 were significantly higher in the lower amniotic fluid compartment than in the upper amniotic fluid compartment (lower compartment: median 2913 pg/ml, range 1360-17 080 pg/ml vs. upper compartment: median 1603 pg/ml, range 1070-8062 pg/ml; p = 0.004.). Spontaneous rupture of the gestational membranes at term was not associated with a significant change in the amniotic fluid concentrations of immunoreactive MCP-1. Conclusions: Immunoreactive MCP-1 is a physiological constituent of the amniotic fluid. The amniotic fluid levels of immunoreactive MCP-1 increase during spontaneous labor at term. A topographic difference in the concentration of immunoreactive MCP-1 was observed in the amniotic cavity, with higher concentrations being noted in the lower amniotic fluid compartment, as compared with the upper amniotic fluid compartment. These findings support the hypothesis that MCP-1 may play a role in the final common pathway of spontaneous labor.

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Topographic differences in amniotic fluid concentrations of prostanoids in women in spontaneous labor at term

Cited by 47 publications

References 8 publications

Characterization of the concentration gradient of prostaglandin H synthase 2 mRNA throughout the pregnant baboon uterus

Characterization of the concentration gradient of prostaglandin H synthase 2 mRNA throughout the pregnant baboon uterus

Amniotic fluid prostaglandin concentrations increase before the onset of spontaneous labor at term

Amniotic fluid levels of immunoreactive monocyte chemotactic protein-1 increase during term parturition

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