Cervical ripening after treatment with prostaglandin E2 or antiprogestin (RU486). Possible mechanisms in relation to gonadal steroids

Ylva Vladic Stjernholm, Y M Stjernholm, Lena Sahlin, L Sahlin, H A Eriksson, Håkan A. Eriksson, B E Byström, Birgitta Byström, Per-Mårten Stenlund, P M Stenlund, G E Ekman, Gunvor Ekman
European Journal of Obstetrics & Gynecology and Reproductive Biology · 1999 · vol. 84(1) , pp. 83–88 · doi:10.1016/s0301-2115(98)00329-7 · PMID:10413233 · W2108324067
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Antiprogestin treatment increased estrogen receptor concentration compared to spontaneous ripening, while prostaglandin E2 treatment increased collagen concentration, suggesting progesterone withdrawal doesn't fully explain spontaneous cervical ripening.

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Abstract

OBJECTIVE: To compare the mechanisms for cervical ripening after treatment with prostaglandin E2 or antiprogestin (RU486) to spontaneous cervical ripening, with focus on gonadal steroid receptors. STUDY DESIGN: Cervical biopsies were obtained from postpartal women after treatment with prostaglandin E2 (n=10), or antiprogestin (n=5). Postpartal women after spontaneous cervical ripening (n=10) served as controls. Levels of estrogen and progesterone receptors, their mRNAs, insulin-like growth factor I mRNA and serum estradiol and progesterone were quantitated. The collagen concentration and solubility by pepsin were determined. Statistical tests used were Kruskal-Wallis and Mann-Whitney U test. RESULTS: After prostaglandin E2 treatment the collagen concentration was higher (P<0.05) as compared to spontaneous ripening. After antiprogestin treatment the estrogen receptor concentration was higher (P<0.05) in comparison to spontaneous ripening. CONCLUSION: The elevated estrogen receptor concentration after antiprogestin treatment, in contrast to spontaneous ripening, and prostaglandin E2 treatment, indicates a that a receptor-mediated progesterone withdrawal does not explain the events behind spontaneous cervical ripening at parturition.

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MeSH descriptors

Cervical Ripening Cervix Uteri Dinoprostone Gene Expression Regulation Mifepristone Receptors, Estrogen Receptors, Progesterone Adult Biopsy Cervical Ripening Cervix Uteri Cervix Uteri Collagen Collagen Dinoprostone Estradiol Estradiol Female Humans Immunoenzyme Techniques

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