PROSTAGLANDIN-E AND F2-ALPHA CONCENTRATION IN THE CERVICAL-MUCUS AND MECHANISM OF CERVICAL RIPENING

Objective: To study the mechanism of cervical ripening by determinatio n of prostaglandin E (PGE) and F-2 alpha (PGF(2 alpha)) concentrations in cervical mucus during the course of pregnancy. Study design: Cervi cal mucus was collected from 99 pregnant women attending the mother ca re unit of the department. Women with sexual intercourse within the la st 24 hours before sampling and subjects with bacterial vaginosis were analysed separately. Results: Eleven women had sexual intercourse wit hin 24 hours before sampling. The concentration of PGE in their cervic al mucus was high corresponding to 2000-4000 pg/mg w w lasting for a p eriod of 10-12 hours postcoitally, whereas the levels of PGF(2 alpha) only increased slightly. Bacterial vaginosis was accomplished by a sli ght but significant elevation of PGF(2 alpha) levels but only of a min or increment of the PGE values. The prostaglandin concentrations in th e mucus from the remaining 68 women were for PGE 102.75 +/- 211.51 and for PGE(2 alpha) 97.54 +/- 82.48 pg/mg w w (mean +/- SD). Although th e values were scattered the concentrations remained at approximately t he same level throughout pregnancy and there was no tendency towards a n increment during the last weeks of pregnancy when cervical maturatio n is apparent. Conclusion: Cervical softening seems not to be accompli shed by a massive local release of prostaglandins but rather the resul t 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. (C) 1997 by Elsevier Science Inc.