The expression of prostaglandin receptors EP3 and EP4 in human cervix in post-term pregnancy differs between failed and successful labor induction.

OBJECTIVE

To investigate expression and localization of prostaglandin receptors EP1-4 and FP and localization of stromal factors CTGF (connective tissue growth factor), furin, calgranulin B and ALOX15 (arachidonate 15-lipooxygenase) in human cervical tissue from post-term women with failed or successful labor induction after prostaglandin priming.

DESIGN

Experimental prospective clinical study.

SETTING

Tertiary obstetric care center.

POPULATION: Twenty-six women giving birth post-term, with failed or successful labor induction, and a control group consisting of 19 women with spontaneous onset of labor and delivery at term.

METHODS

Biopsies were obtained from post-term women with successful (responders; R) and failed (non-responders; NR) labor induction. Women with spontaneous delivery at term were included as controls (C). mRNA expression was determined with real time PCR, protein expression and localization with immunohistochemistry.

MAIN OUTCOME MEASURES: Comparisons of mRNA and protein expressions between post-term pregnancies with failed and successful labor induction as well as term controls.

RESULTS

EP4 mRNA expression was down-regulated concomitant with an up-regulation of EP3 mRNA expression in cervix from the NR group as compared with the R group. In stroma, immunoreactivity of the EP4 protein was increased in the NR group as compared with R and C groups.

CONCLUSIONS

Failure of cervical ripening, after local application of prostaglandins for labor induction, may be caused by the increased expression of EP3 and concomitant decrease in EP4 expression.