Induction of term labor with intravenous prostaglandin F2α (a comparison of two dosage schedules)

The efficacy of intravenous Prostaglandin F_2α (PGF_2α) infusion for induction of labor in two different dosage schedules was studied in 90 women between 36 and 43 weeks of gestation. The rate of PGF_2α infusion was increased at four-hour intervals in 36 women in the low dosage group and every hour in 54 women in the high dosage group, never exceeding an infusion rate of 20 μg/min. in either group. Labor was successfully induced in approximately 90% of the patients in each group. There was no statistically significant difference in the mean induction-delivery interval between the two groups at the 5 percent level. Intravenous PGF_2α was found to be effective and safe for both mother and infant in the dosage schedules used in this study for induction of labor.     

The induction of labour by the intravenous infusion of prostaglandin F2alpha

Labour was induced by the intravenous infusion of prostaglandin F2alpha in 106 patients at 36-44 weeks of pregnancy. The induction was successful in 80% of the women. The total dose needed ranged from 0.1 to 14.2 mg of PGF2alpha. The uterine activity and fetal heart rate were recorded by cardiotocography. The contraction pattern and induction-delivery time were the same as reported for induction with oxytocin. In one case uterine hyperactivity occurred after rupture of the membranes. No serious adverse effects were seen, but in a few cases local irritation was noted at the site of infusion. The condition of the infants was generally good. It might be concluded that PGF2alpha seems valuable for the induction of labour, but due to the risk for over-stimulation careful supervision is needed.     

Serum PGF2 alpha levels during late pregnancy, labour and the puerperium

The serum prostaglandin (PG) F2alpha levels of women in the last trimester of pregnancy have been measured and compared with the levels found in samples taken during labor, during the 1st week postpartum, and from nonpregnant women. The laboratory procedures for drawing the samples and making the radioimmunoassay measurements are explained. 40 samples were taken during late pregnancy, 46 during labor, 7 during the 1st week postpartum, and 8 from nonpregnant women. The results are graphed. PGF2alpha levels during late pregnancy resemble those found in nonpregnant women. A significant rise (p.05) occurs during labor, most markedly during the late 1st stage. Levels during the 1st week postpartum were found to be very low. There was no difference between serum levels during the 33rd-36th weeks and those found during weeks 34-40. Serum levels did not differ according to whether labor was spontaneous, induced by artificial rupture of fetal membranes and infusion of Syntocinon, or merely accelerated by syntocinon infusion. This indicates that PG release occurs as a result of labor rather than as a triggering mechanism for the onset of labor. The highest levels of serum PGF2alpha seem to be associated with the time of greatest uterine activity and the period of greatest cervical stretching.     

Induction of term labor with intravenous PGF2 alpha: a review

Studies of prostaglandins (PGs) used for term labor induction are reviewed, and aside from a slight tendency toward developing hypertonus with PGF2 alpha, evidence suggests that prostaglandins for labor induction, while no better than oxytocin, are equally efficacious. After the discovery of PGF2 alpha in the decidua of term pregnant uterus, impetus for research was found. Research first tended to record uterine activity, and next dose-response studies were performed. For labor induction studies, a double-blind study of 300 patients found a comparative advantage in efficacy of PGE2 over PGF2 alpha combined with oxytocin. Other double-blind studies reported an apparent synergism between oxytocin and PGE2 or, on the contrary, reported no difference in efficacy. Anderson's protocol design, using a double-blind protocol with Bishop score-classified patients before induction, has been modified but remains the basis of most protocols. Only in special situations has PGF2 alpha been found more efficacious than oxytocin; such situations are missed abortion, intrauterine death, molar gestations, and anencephalic pregnancy. 1 researcher suggests PGF2 alpha is indicated in patients with very low Bishop scores. Studies on the safety of prostaglandins for labor induction, for both child and mother, have generally concluded that if uterine hyperstimulation is avoided, there will be no serious sequelae. Hypertonus can be avoided by using step-wise dose increases based on labor progression, rather than fixed dose amounts. Also, in terms of safety, there is a possible advantage of PGF2 alpha over oxytocin in the area of antidiuresis, since 1 study has shown that PGF2 alpha has no antidiuretic effect.     

Effect of prostaglandin F2 alpha on the secretion of human prolactin

This study examines the role of PGF2a (prostaglandin F2alpha) in increasing the secretion rate of human prolactin. 11 women (mean gestational period, 18 weeks) seeking pregnancy termination were divided into 4 groups: 1) Group 1 consisted of 6 women who received 30 mg initially of PGF2a injected intramuscularly and an additional 15 mg after 24 hours if abortion had not occured; mean induction to termination period was 38 hours; 2) Group 2 comprised of 3 women who received PGF2a (500-1500 ug) via the transcervical route at 1 to 2 hourly interval; average number of injections was 20; mean induction to termination period, 24 hours; 3) Group 3 had 2 women receiving hypertonic saline by intraamniotic injection; mean induction to termination period was 51 hours; 4) Group 4 had 4 women who served as controls; mean observation period, 20 hours. Venous blood samples were heparinized in tubes at intervals of 2 to 3 hours. A homologous radioimmunoassay using highly purified human prolactin (for iodination and standards) plus rabbit antihuman prolactin measured serum prolactin. Spikes of serum prolactin up to 550 ng/ml were observed at irregular intervals in 5 women in Group 1; the spikes were less frequent and of smaller amplitude in Groups 3 and 4. The increase in serum prolactin was dramatic and more sustained in Group 2 patients and peaked towards the end of the prostaglandin infusion. Serum prolactin of Group 2 patients were significantly higher than those of Groups 3 and 4 (p0.01). 5 of 9 women whose pregnancies were terminated by PGF2a lactated. However, there was no significant difference between the mean serum prolactin levels in women who lactated (136 ng/ml) and those who did not (120 ng/ml). Although PGF2a is not a lactogenic hormone, this study shows that PGF2a stimulates the secretion of human prolactin during second trimester pregnancy. The fact that the transcervical route caused a significant increase in serum prolactin and the intraamniotic route did not is attributed to the increased systemic absorption of PGF2a following transcervical administration. No correlation was seen between the presence or absence of lactation and the serum prolactin level following pregnancy termination with PGF2a.     

Effect of prostaglandin F2alpha on ovarian and pituitary function in the mid-luteal phase.

The effects of PGF2alpha infusion in a dose of 25 micrograms/min for 5 hours on serum levels of estradiol-17beta, progesterone, LH, FSH, TSH and prolactin, and on the pituitary hormone responsiveness to LRH and TRH were studied in 10 apparently healthy cycling women in the mid-luteal phase. No systematic alteration was seen in the pituitary and ovarian hormone levels during PGF2alpha infusion, and the pituitary hormone responses to releasing hormones were unaffected. Ovarian steroid production increased in response to increased gonadotropin levels after LRH injection during PGF2alpha administration. These results confirm that PGF2alpha is not luteolytic in humans and no apparent relationship between PGF2alpha and pituitary hormone secretion exists.     

Amniotic fluid concentrations of prostaglandin F2 alpha, 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) and 11-deoxy-13,14-dihydro-15-keto-11, 16-cyclo-prostaglandin E2 (PGEM-LL) in preterm labor

Although prostaglandins (PGs) are considered the key mediators of human parturition at term, there is a paucity of data regarding their participation in the mechanisms responsible for preterm labor. The purpose of this study was to establish if preterm labor is associated with changes in the amniotic fluid concentrations of prostaglandins. PGF2 alpha, 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) and 11-deoxy-13,14-dihydro-15-keto-11,16-cyclo-prostaglandin E2 (PGEM-ll) were measured by using specific and sensitive radioimmunoassays. Amniotic fluid was retrieved by transabdominal amniocentesis from 55 women with preterm labor and intact membranes. Patients were divided into three groups according to the response to tocolysis and the presence or absence of an intra-amniotic infection. Amniotic fluid concentrations of PGFM and PGEM-ll were significantly greater in women with preterm labor and intra-amniotic infection than in women without infection. In addition, patients unresponsive to tocolysis without intra-amniotic infection also had a significantly greater concentration of PGFM and PGEM-ll in amniotic fluid than those responsive to tocolysis. Amniotic fluid concentrations of PGF2 alpha were greater in women with intra-amniotic infection than in women without intra-amniotic infection. In the absence of intra-amniotic infection, no difference in amniotic fluid PGF2 alpha concentrations could be found between women who responded to tocolytic treatment and those who did not.     

Changes in the plasma prostaglandin F2 alpha metabolite before and during spontaneous labor and labor induced by amniotomy, oxytocin and prostaglandin E2

To elucidate the role of endogenous prostaglandin F2 alpha in spontaneous and induced labor, plasma concentrations of 13, 14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) were determined before the onset of labor, at onset of labor, during active labor, at the crowning of the fetal head, and 1 and 2 hours after delivery. Patients in spontaneous labor and labor induced by amniotomy, oxytocin, and prostaglandin E2 were studied. The levels of plasma PGFM in patients who entered spontaneous labor fell 2 to 3 weeks before delivery, whereas those in the induced labor group did not change until the time of induction. Although the levels of PGFM rose gradually with the progress of labor in all cases, the levels in the spontaneous labor were significantly lower in each stage than in the corresponding stage of induced labor. These results suggest that endogenous prostaglandin F2 alpha (PGF2 alpha) production decreases 2-3 weeks prior to the spontaneous onset of labor and is increased again as labor progresses, that the patterns of PGF2 alpha production are similar to each other during spontaneous labor and labor induced by various methods. Therefore, it is felt that endogenous PGF2 alpha may participate in the progress of all kinds of labor.     

Estrus synchronization and fertility in post-partum dairy cattle after administration of human chorionic gonadotrophin (HCG) and prostaglandin F2 alpha analog

Human chorionic gonadotrophin (hCG) plus PGF2 alpha was compared with GnRH plus PGF2 alpha for estrus synchronization of dairy cows. There were 3 treatments: GnRH analog (Buserelin, 12.6 micrograms) plus PGF2 alpha analog (Cloprostenol, 150 micrograms) 6 d later (GnRH + PGF[Day 6]); hCG (2000 IU) plus PGF2 alpha 9 d later (hCG + PGF[Day 9]); and hCG plus PGF2 alpha 6 d later (hCG + PGF[Day 6]). Treatment occurred either Days 55 to 90 or Days 91 to 135 post partum. For responses during the first 10 d after PGF2 alpha administration, estrus synchronization (P = 0.24), efficacy (percentage of treated pregnant; P = 0.20) and conception (percentage of inseminated pregnant; P = 0.23) rates were not different among the 3 treatments. Cows treated between Days 55 and 90 had a higher rate (P < 0.05) of detected estrus during this period (69% for GnRH + PG [Day 6], 70% for hCG + PGF[Day 9] and 72% for hCG + PGF[Day 6]) compared with cows treated between Days 91 and 135 (52% for GnRH + PGF[Day 6], 50% for hCG + PGF[Day 9] and 57% for hCG + PGF[Day 6]). Efficacy of treatment was higher (P < 0.05) in animals treated between Days 55 and 90 (54% for GnRH + PGF[Day 6], 56% for hCG + PGF[Day 9] and 63% for hCG + PGF [Day 6]) compared to animals treated between Days 91 and 135 (36% for GnRH + PGF[Day 6], 35% for hCG + PGF[Day 9] and 47% for hCG + PGF[Day 6]). There were no significant differences in conception between Days 51 and 90 and Days 91 and 135. The interval between parturition-first AI with conception was significantly (P < 0.001) shorter in GnRH + PGF (Day 6; 106 d), hCG + PGF (Day 9; 109 d) and hCG + PGF (Day 6; 103 d) treated cattle than in 106 untreated animals (136 d). Thus, GnRH plus PGF2 alpha or hCG plus PGF2 alpha treatments elicited similar effects in estrus synchronization, treatment efficacy, and conception rate in post-partum dairy cows.     

Timing of final GnRH of the Ovsynch protocol affects ovulatory follicle size,subsequent luteal function,and fertility in dairy cows

Synchronization of ovulation (Ovsynch) is an effective method for controlling time of first and subsequent AI in lactating dairy cows. However, validation of the original Ovsynch program did not include testing the optimal time to deliver the final treatment of GnRH. In Experiment 1, the effect of administering the final dose of GnRH on the same day as prostaglandin F2alpha (PGF2alpha) administration was tested. Lactating dairy cows (n = 218) were randomly assigned to receive either Ovsynch (OV; cows were given 100 microg GnRH, then 7 days later cows were administered 25mg PGF2alpha followed by a subsequent treatment of 100 microg GnRH 2 days after the PGF2alpha or the modified version of Ovsynch (MOV; cows were given 100 microg GnRH, then 7 days later cows were administered 25mg PGF2alpha followed immediately with 100 microg GnRH). In both treatment groups, AI took place 16 h after the final administration of GnRH. In Experiment 2, cows (n = 457) were randomly divided into four treatment groups that were administered GnRH 0, 12, 24 and 36 h following PGF(2alpha). The 36 h treatment group served as control. Pregnancy diagnoses were performed by palpation per rectum 36 days post-AI in Experiment 1 and by ultrasonography on Day 28 in Experiment 2. In Experiment 1, pregnancy rate/AI (PR/AI) was greater (P<0.025) in OV versus MOV. In a subset (n = 85), percentage of cows with both synchronized ovulations and regressed CL following administration of PGF2alpha were similar (P>0.1) between OV and MOV, respectively. All cows that became pregnant in the MOV subset group showed regression of the CL in response to the PGF2alpha. Diameter of the ovulatory follicle at the time of final GnRH administration was greater (P<0.05) in OV versus MOV. In Experiment 2, the synchronization rate was once again similar among treatments (P>0.28). There was a linear effect of treatment on follicle size (P<0.05) and PR/AI (P<0.0001) as time increased between administration of PGF2alpha and GnRH, with the greatest PR/AI at 36 h. There was a trend for a greater percentage of cows with short luteal phases in the 0 h group (P<0.10). In summary, delivering the final treatment of GnRH of the Ovsynch program at the same time as PGF2alpha, or in the 24h following PGF2alpha, resulted in lower fertility compared to controls.     

Comparison of intra-amniotic prostaglandin F2 alpha and hypertonic saline for induction of second-trimester abortion.

The efficacy and safety of intra-amniotic prostaglandin (PG) F2 alpha (25 mg repeated in six hours) and hypertonic saline (200 ml 20% NaC1) were compared in an international multicentre randomised study organised by the World Health Organisation''s prostaglandin task force. Both hypertonic saline and PGF2alpha were found to be effective in terminating second-trimester pregnancy. The main advantage of PGF2alpha however, was its greater efficacy, with significantly higher success rates in the first 48 hours. Out of 717 women given PGF2alpha 614 (85-6%) aborted within 48 hours; by 24 hours 439 (61-2%) had aborted, and by 36 hours 574 (80-1%) had aborted. Out of 796 women given hypertonic saline 641 (80-5%) aborted within 48 hours; however, by 24 and 36 hours, respectively, only 161 (20-2%) and 462 (58%) had aborted. Although PGF2alpha was associated with a somewhat higher frequency of minor side effects than hypertonic saline, notably vomiting and diarrhoea, these were within acceptable limits. Only 59 women (8-2%) in the prostaglandin group had more than four episodes of vomiting and 11 (1-5%) more than four episodes of diarrhoea. Ohter side effects occurred only occasionally. No difference was found between the two groups in the frequency of incomplete abortion or excessive bleeding.     

Role of luteinizing hormone in changes in concentrations of progesterone and luteal blood flow during the hours of a simulated pulse of 13,14-dihydro-15-keto-prostaglandin F(2alpha) (PGFM) in heifers

A bolus treatment (e.g., 25 mg) of prostaglandin F(2alpha) (PGF) in the study of luteolysis in cattle results in dubious interpretations. Therefore, in experiment 1 of the present study, a 13,14-dihydro-15-keto-PGF (PGFM) pulse was simulated by incremental intrauterine (IU) infusion of PGF for 2.7 h on Day 14 postovulation. Concentrations of PGFM during the first hour of infusion and at the maximum were not different between simulated (n = 7) and spontaneous (n = 7) pulses. In experiment 2, four groups (n = 6 per group) were treated at Minute 0 (beginning of infusion) as follows: saline (infused IU), PGF (infused IU), acyline/saline, and acyline/PGF. Two hours before Minute 0, each heifer was given flunixin meglumine to inhibit endogenous PGF secretion, and heifers in the acyline/saline and acyline/PGF groups were given acyline to inhibit luteinizing hormone (LH). Plasma progesterone concentrations were similar among groups during Minutes 0 to 60, with no indication of an initial transient progesterone increase in the two PGF groups. Progesterone began to decrease in the PGF groups at Minute 60 and to rebound at Minute 135 after the PGFM peak at Minute 120. The rebound was complete in association with an increase in LH in the PGF group, but it was not complete when LH was inhibited in the acyline/PGF group. Luteal blood flow increased during PGF infusion in the two PGF groups and remained elevated for approximately 2 h after the PGFM peak in the PGF group but not in the acyline/PGF group. Novel findings were that an initial transient increase in progesterone did not occur with the simulated PGFM pulse and that LH stimulated a progesterone rebound and maintained the elevated luteal blood flow after the PGFM peak.     

Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis.

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.     

In vivo desensitization of a high affinity PGF2 alpha receptor in the ovine corpus luteum.

The corpus luteum (CL) of the sheep exhibits a differential sensitivity to PGF2 alpha in vivo in terms of an increase in oxytocin (OT) secretion and a decrease in progesterone secretion, pointing to the presence in vivo of both high and low affinity receptors for PGF2 alpha. The presence of the high affinity PGF2 alpha receptor was assessed by monitoring the secretion rate of OT from the ovine CL in response to subluteolytic infusions of PGF2 alpha. Rapid desensitization to PGF2 alpha occurred after only one hour of infusion, while a minimum rest period of six hours was required to restore sensitivity. The possibility that these findings could be explained by the depletion and resynthesis of OT was excluded by demonstrating an increase in OT secretion rate with supra-physiological levels of PGF2 alpha two hours after desensitization. Collectively, these results indicate the presence of a high affinity receptor for PGF2 alpha in the ovine CL which exhibits desensitization and recovery in vivo. The temporal nature of the desensitization and recovery of the high affinity PGF2 alpha receptor controlling luteal OT secretion may contribute to the pulsatile nature of PGF2 alpha release from the ovine uterus.     

Resynchronization of ovulation and timed insemination in lactating dairy cows III. Administration of GnRH 23 days post AI and ultrasonography for nonpregnancy diagnosis on day 30

The objective was to compare pregnancy rates to resynchronization and timed AI (TAI) protocols in lactating dairy cows that received GnRH at 23 d and were diagnosed not pregnant at 30 d after the pre-enrollment AI. Nonpregnant cows (624) at ultrasonography on day 30 (study day 0) were classified as diestrus (74.8%), metestrus (5.6%) and without a CL (19.5%). Cows in diestrus were assigned either to the GnRH group (PGF2alpha on day 0, GnRH on day 2 and TAI 16 h later, n = 238) or the estradiol cypionate (ECP) group (PGF2alpha on day 0, ECP on day 1, and TAI 36 h later, n = 229). Cows in metestrus were assigned to the Modified Heatsynch Group (GnRH on day 0, PGF(2alpha) on day 7, ECP on day 8 and TAI on day 9, n = 35). Cows without a CL (n = 122) were classified either as proestrus (10.6%), ovarian cysts (7.5%) or anestrus (1.4%), and assigned to factorial treatments (i.e., use of GnRH versus CIDR) to either the GnRH group (GnRH on day 0, PGF2alpha on day 7, GnRH on day 9 and TAI 16 h later, n = 28), the CIDR group (CIDR insert from days 0 to 7, PGF2alpha on day 7, GnRH on day 9 and TAI 16 h later, n = 34), the GnRH + CIDR group (GnRH on day 0, CIDR insert from days 0 to 7, PGF2alpha on day 7, GnRH on day 9 and TAI 16h later, n = 32), and the control group (PGF2alpha on day 7, GnRH on day 9 and TAI 16 h later, n = 28). For cows without a CL, plasma P4 concentrations were determined on days 0, 7, 10 and 17 and ovarian structures determined on days 0, 7 and 17. Pregnancy rates were evaluated at 30, 55 and 90 d after the resynchronized AI. For cows in diestrus, there were no differences in pregnancy rates on days 30, 55 and 90 for cows in the GnRH (27.5, 26.5 and 24.2%) or ECP (29.1, 25.5 and 24.1%) groups. In addition, there were no differences in pregnancy losses between days 30 and 55 and 55 and 90 between the GnRH (7.0 and 8.6%) and ECP (9.8 and 5.4%) groups. For cows without a CL, GnRH on day 0 increased the proportion of cows with a CL on days 7 and 17 and plasma P4 concentration on day 17 in cows with ovarian cysts but not for cows in proestrus. The CIDR insert increased pregnancy rate in cows with ovarian cysts but reduced pregnancy rate for cows in proestrus.     

Absence of uterokinetic effects of prostaglandin F 2 alpha on oxytocin-reactive uterus in the mare

In most cyclic females, prostaglandin F(2alpha) (PGF(2alpha)) triggers a uterine motility response resembling that of oxytocin (OT). To determine if PGF(2alpha) is a uterokinetic substance in the cycling mare, uterine motility was measured by intrauterine balloon technique in 12 conscious, normally cyclic mares. After 60 min of saline infusion, continuous intravenous (i.v.) infusion with OT (1 i.u./min) was followed by PGF(2alpha) (200 mug/min) for 60 min each. The experiment was repeated 3 wk later except with PGF(2alpha) preceeding OT. A second group of mares was administered OT (60 i.u.) either i.v., intramuscularly (i.m.), or intrauterinely (i.u.). Plasma samples were studied for progesterone concentration. Control uterine motility for the first group of mares was (mean +/- SEM) 545.83 +/- 45.10 mm(2). Significant (P<0.05) elevation in uterine motility was recorded for OT (1118.60 +/- 70.56 mm(2)) regardless if PGF(2alpha) preceded OT infusion or vice-versa. No significant difference (P>0.05) was seen in motility after PGF(2alpha) (423.33 +/- 31.12 mm(2)) infusion. The uterokinetic effect of OT was greatest when OT was administered i.v. (1696.50 +/- 195.46 mm(2)) followed by i.m. (819.82 +/- 39.96 mm(2)), and it was least effective when administered i.u. (607.83 +/- 21.56 mm(2)) as compared to control uterine motility (279.78 +/- 22.33 mm(2)). Skin electrical resistance values rose from 0 to 2000 ohms with PGF(2alpha) infusion (but not with OT), indicating that PGF(2alpha) was bioactive. It was concluded that PGF(2alpha) was not a uterokinetic substance in the cyclic mare.     

On the influence of prostaglandin F2alpha-induced labor at term on the metabolism and coagulation of mother and fetus.

11 pregnancies at term were terminated by dilatation of the uterine cervix, low amniotomy, and by intravenous administration of PGF2alpha. The average infusion time was 3 hours 55 minutes, and the average total dose of PGF2alpha amounted to 2.0 mg. Parameters of acid-base changes, carbohydrate and energic state changes, gas metabolism, and changes in coagulation and fibrinolysis in mother and in fetus were analyzed during labor and after birth. Labor activity and fetal cardiac action were monitored cardiotocographically. Checked against 50 uncomplicated spontaneous deliveries, we found no disadvantageous changes in the parameters investigated.     

Estradiol-17 beta and 2-hydroxyestradiol-17 beta-induced differential production of prostaglandins by cells dispersed from human intrauterine tissues at parturition

Prostaglandin (PGE, 6-keto PGF1 alpha) output by cells dispersed from human amnion and decidua in the presence of increasing levels (0-5000 ng/ml) of estradiol-17 beta (E2) or 2-hydroxyestradiol-17 beta (2-OH E2) was studied in relation to parturition. Tissues were obtained from women at term either before (CS) or after (SL) spontaneous labor and vaginal delivery. In the absence of estrogens, the output of both PGs from amnion increased significantly with labor. No significant increase in decidua PG output occurred with labor. Neither estrogen influenced CS amnion PG output. However, both E2 and 2-OH E2 stimulated SL amnion PGE output (2-OH E2 greater than E2) while having no affect on 6-keto PGF1 alpha output. Only the highest dose of 2-OH E2 stimulated PGE output in CS decidua, but both estrogens significantly inhibited 6-keto PGF1 alpha output in this tissue. In SL decidua only 2-OH E2 significantly stimulated PGE, and neither estrogen affected 6-keto PGF1 alpha output. These results might suggest that estrogens modulate PG biosynthesis at the level of endoperoxide to primary PG conversion.     

Study of oxytocin receptor: II. oxytocin and prostaglandin F2 alpha receptors in human myometria and amnion-decidua complex during pregnancy and labor

Oxytocin receptors (OXT-R) and prostaglandin F2 alpha receptors (PGF2 alpha-R) in human myometrium, amnion and decidua during pregnancy and at parturition were examined in an effort to clarify their role in the initiation and maintenance of uterine contractions. The number of binding sites for OXT in myometria showed an increase as gestation advance (Ist trimester v.s. at term; 205 +/- 90 v.s. 671 +/- 98 fmol/mg protein, N = 5, p less than 0.01), and a rapid decrease following the onset of labor (254 +/- 60 fmol/mg protein, N = 5, p less than 0.02). On the other hand the number of PGF2 alpha-R, remained unchanged throughout pregnancy and in labor. This myometrial PGF2 alpha binding capacity was approximately 1/20 to 1/30 that of the OXT binding, while binding affinity was almost equal. The OXT-R both in amnion and decidua, which was 1/6 to 1/7 that in myometrium, showed no significant changes throughout pregnancy or after the onset of labor. Binding affinity for each tissue was almost the same and appeared to increase towards term but no statistical significance was detected. Present data confirmed the presence of OXT as well as PGF2 alpha receptors in the three functionally distinct entities of pregnant human uterus; myometrium, amnion, and decidua. Among the components, the OXT binding increased only in the myometrium during pregnancy, suggesting this tissue specifically responds to OXT. In contrast, there was a constant binding in myometria for PGF2 alpha.(ABSTRACT TRUNCATED AT 250 WORDS)     

Farrowing induction with a combination of prostaglandin F(2alpha) and a peripherally acting alpha(2)--adrenergic agonist AGN 190851 and a combination of prostaglandin F(2alpha) and oxytocin

We studied the effect of prostaglandin (PG) F(2alpha)-AGN 190851 on farrowing induction and compared it with that of PGF(2alpha)-oxytocin. Eighty crossbred, multiparous sows were randomly assigned to the following 4 treatment groups of 20 sows each: 1) control, saline-saline; 2) PGF(2alpha) (10 mg/sow)-oxytocin (30 IU/sow); 3) PGF(2alpha) (10 mg/sow)-AGN 190851 (0.06 mg/kg); and 4) PGF(2alpha) (10 mg/sow)-AGN 190851 (0.1 mg/kg). Either PGF(2alpha) or saline was administered intramuscularly on Day 111 of gestation at 11:30 h; AGN 190851, oxytocin or saline was administered intramuscularly 20 h after the first injection. The PGF(2alpha)-AGN 190851 (0.1 mg/kg) treated sows had the shortest mean farrowing interval (2.1 +/- 1.6 h, mean +/- SD) compared with the remaining treatment groups (control: 67.1 +/- 26.2 h; PGF(2alpha)-oxytocin: 5.6 +/- 6.7 h; PGF(2alpha)-AGN 190851 [0.06 mg/kg]: 3.0 +/- 2.8 h). Duration of farrowing, litter size, litter weight and interval from weaning to first estrus in sows were not significantly changed by these treatments. The PGF(2alpha)-oxytocin group had a significantly higher stillbirth rate than the control group, whereas the PGF(2alpha)-AGN 190851 (0.1 mg/kg) group had the lowest number of pigs born dead and stillbirth rate among the 4 treatment groups. These results suggested that the PGF(2alpha)-AGN 190851 combination can be used as an alternative method to PGF(2alpha)-oxytocin for synchronizing farrowing.