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

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 84; no. 1; pp. 83 - 88
• Main Authors: Stjernholm, Ylva M., Sahlin, Lena, Eriksson, Håkan A., Byström, Birgitta E., Stenlund, Per-Mårten, Ekman, Gunvor E.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.05.1999; Elsevier
• Subjects: Adult; Antiprogestin; Biological and medical sciences; Biopsy; Cervical ripening; Cervical Ripening - drug effects; Cervix Uteri - physiology; Cervix Uteri - surgery; Collagen - analysis; Dinoprostone - therapeutic use; Estradiol - blood; Estrogen receptor; Female; Gene Expression Regulation; Hormones. Endocrine system; Humans; Immunoenzyme Techniques; Insulin-Like Growth Factor I - analysis; Medical sciences; Medicin och hälsovetenskap; Mifepristone - therapeutic use; Pharmacology. Drug treatments; Pilot Projects; Progesterone - blood; Progesterone receptor; Prostaglandin E2; Receptors, Estrogen - analysis; Receptors, Estrogen - physiology; Receptors, Progesterone - analysis; Receptors, Progesterone - physiology; RNA Probes - chemistry; RNA, Messenger - chemistry; Prostaglandin E2; Estrogen receptor; Antiprogestin; Cervical ripening; Progesterone receptor; Human; Arachidonic acid derivatives; Spontaneous; Estrogen; Receiver; Uterine cervix; Ripening; Chemotherapy; Treatment; Biological effect; Progesterone; Comparative study
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(98)00329-7

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.