Prostacyclin and hormone levels in patients with symptoms of miscarriage and infection.

During pregnancy, acsending infection into the uterus, is followed by local increase of cyclooxygenase-2 (COX-2) activity, and consequently elevated prostaglandin production. Subclinical infections of fetal amniotic membranes are well known to cause preterm delivery. Spreading of infection from vagina and cervix into uterine cavity, can be tragic for the fetus. The aim of this study was to reveal wether lower genital tract infections are associated with symptoms of threatened miscarriage. Our investigation included 140 patients with symptoms of threatened miscarriage and 70 patients with uncomplicated pregnancies. Infections were detected by vaginal or cervical smears as well as tests for Chlamydial infection. Levels of prostacyclin, main prostaglandin product during pregnancy, were evaluated via its stable metabololite, 6-keto-PGF1-alpha. Both prostaglandin levels and hormones were determined by ELISA method. We found that serum values of prostacyclin were elevated, while levels of estradiol, progesterone and prolactin were significantly lower in patients with lower genital tract infections. Increased prostacyclin levels in pregnancies complicated by lower genital tract infections are caused by stimulation of COX/2 enzyme, due to elevated production of various cytokines which are possibly a compensatory mechanism resolving problems caused by bacterial endotoxines.