dinoprost and Vaginosis--Bacterial

To study the mechanism of cervical ripening by determination of prostaglandin E (PGE) and F2 alpha (PGF2 alpha) concentrations in cervical mucus during the course of pregnancy.. Cervical mucus was collected from 99 pregnant women attending the mother care unit of the department. Women with sexual intercourse within the last 24 hours before sampling and subjects with bacterial vaginosis were analysed separately.. Eleven women had sexual intercourse within 24 hours before sampling. The concentration of PGE in their cervical mucus was high corresponding to 2000-4000 pg/mg w w lasting for a period of 10-12 hours postcoitally, whereas the levels of PGF 2 alpha only increased slightly. Bacterial vaginosis was accomplished by a slight but significant elevation of PGF2 alpha levels but only of a minor increment of the PGE values. The prostaglandin concentrations in the mucus from the remaining 68 women were for PGE 102.75 +/- 111.51 and for PGF2 alpha 97.54 +/- 82.48 pg/mg w w (mean +/- SD). Although the values were scattered the concentrations remained at approximately the same level throughout pregnancy and there was no tendency towards an increment during the last weeks of pregnancy when cervical maturation is apparent.. Cervical softening seems not to be accomplished by a massive local release of prostaglandins but rather the result of a number of different mechanisms more or less influenced by minor alterations of prostaglandin synthesis and release. Involved in these mechanisms are probably neutrophil-derived collagenases.

Topics: Analysis of Variance; Cervix Mucus; Cervix Uteri; Coitus; Dinoprost; Female; Humans; Pregnancy; Pregnancy Trimester, First; Prostaglandins E; Time Factors; Vaginosis, Bacterial

Cervical dilatation and softening after pretreatment with mifepristone are well documented. As this effect is similar to that observed after local application of prostaglandin E2 (PGE2) it is tempting to speculate that the effect of mifepristone is mediated via an increase of the endogenous secretion of prostaglandins from the cervical mucosa. Eighteen healthy women in the first trimester of pregnancy were treated with oral mifepristone (200 mg) 48 and 24 hours before legal abortion by vacuum aspiration and 18 women in the same age of gestation without any pretreatment served as controls. Cervical mucus was collected for measurement of prostaglandins by radioimmunoassay before administration of the drug and in connection with vacuum aspiration. The cervical dilatation at the time of surgery was significantly increased in women given mifepristone as compared with untreated women (7.6 versus 5.8 mm). The wet weight of collected cervical mucus was significantly increased in mifepristone treated women. The amount of PGE2 and prostaglandin F2 alpha per sample was unchanged in mifepristone-treated women, whereas the concentration was lower as an effect of dilution due to an increased yield in cervical secretion observed after mifepristone treatment. The present observation does not give any support to the hypothesis that mifepristone-induced cervical maturation is mediated via an increase in cervical prostaglandin production.

Topics: Abortion, Legal; Adult; Cervix Mucus; Cervix Uteri; Chlamydia Infections; Chlamydia trachomatis; Dilatation and Curettage; Dinoprost; Dinoprostone; Female; Gestational Age; Humans; Mifepristone; Nausea; Pregnancy; Pregnancy Trimester, First; Time Factors; Vaginosis, Bacterial

Topics: Dinoprost; Dinoprostone; Female; Gardnerella vaginalis; Humans; Obstetric Labor, Premature; Pregnancy; Risk Factors; Ureaplasma urealyticum; Vaginosis, Bacterial

Microorganisms associated with bacterial vaginosis are commonly recovered from the amniotic fluid and chorion-amnion of patients who deliver prematurely. Bacteria closely related to those causing bacterial vaginosis may play a role in the initiation of uterine contractions, ripening of the cervix and weakening of the fetal membranes by stimulating prostaglandin synthesis. In the present investigation, cervical mucus was collected by brush from early pregnant women with and without bacterial vaginosis. The concentrations of PGE2, PGF2 alpha and 6-keto-PGF1 alpha were determined in the mucus samples by methyl oximation and then radioimmunoassay, utilizing antibodies raised against oximated prostaglandins. It was found that the concentration of PGE2 and PGF2 alpha was significantly higher in the mucus of women with bacterial vaginosis compared with healthy women. The concentration of 6-keto-PGF1 alpha was similar in both study groups. All patients had been instructed to abstain from sexual intercourse for 24 hours before sampling. However, it may be that women with high concentrations in their mucus may have had intercourse anyway. However, it is fairly well possible that the significant differences in the PGE2 and PGF2 alpha values are causally related to the higher rate of preterm labor in women with the commonplace infection of bacterial vaginosis.

Topics: 6-Ketoprostaglandin F1 alpha; Cervix Mucus; Dinoprost; Dinoprostone; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Prostaglandins F; Vaginosis, Bacterial