CERVICAL FETAL FIBRONECTIN CORRELATES TO PROSTAGLANDIN E-2-INDUCED CERVICAL RIPENING AND CAN BE IDENTIFIED IN CERVICAL TISSUE

OBJECTIVE: Our purpose was to investigate whether prostaglandin E-2-in duced cervical ripening can be related to changes in fetal fibronectin levels and whether fetal fibronectin can be detected by immunohistoch emistry in amniotic and cervical tissue. STUDY DESIGN: Fetal fibronect in levels in cervical mucus were quantitated in 28 nulliparous term pr egnant women with unfavorable cervical states before and after intrace rvical application of prostaglandin E-2 gel. The concentration of feta l fibronectin was determined with use of an enzyme immunoassay. Cervic al biopsy specimens and amniotic tissue for immunohistochemical analys is were obtained from three term pregnant women and after parturition in three women. Cervical biopsy specimens from two nonpregnant women s erved as controls. Immunohistochemical analysis was performed with ant ibodies directed toward fetal fibronectin. RESULTS: The fetal fibronec tin level in cervical mucus was low in all women before prostaglandin E-2 application. In women with a successful prostaglandin E-2-induced ripening (i.e., an increase of cervical score with greater than or equ al to 3 points), a tenfold increase in the fetal fibronectin level was registered. In women with an insufficient cervical ripening after pro staglandin E-2 treatment no significant increase in the fetal fibronec tin level was registered. The immunohistochemical analyses have identi fied fetal fibronectin in the epithelial cells of the cervix uteri. CO NCLUSION: Successful prostaglandin E-2-induced cervical ripening seems to be related to a significant increase in cervical fetal fibronectin levels. Fetal fibronectin can be detected immunohistochemically in th e pregnant human cervix.