Physiological and biochemical implications of prostaglandins from the perspective of developing safer first and second-trimester obstetrics.

Hungary has experienced one of the highest prematurity rate of the world due to the large number of induced abortions carried out by rapid mechanical dilation of the cervix during the last three decades. With the pioneering work of Professor Sune Bergström in the identification and isolation of the primary, naturally occurring prostaglandins and in elucidating their chemical structure, it became possible also in Hungary to start research with the help of the Swedish investigators and WHO assistance on the clinical application of PGs. Recently growing understanding of cervical physiology promotes their use for cervical dilatation and for pharmacological uterine stimulation which is especially important in Hungary from the perspective of changing the recent situation, i.e. preventing cervical incompetence and subsequent "short-gestations" in future pregnancies. The physiologic importance of the development of the PG-analogues with slowed-down metabolic degradation is outlined here. The implications of the PGs in cervical ripening is reviewed, and the role of the cervix,--as an endocrine gland, playing a biochemically preprogrammed role in controlling a wide array of physiological processes throughout human gestation--, is discussed.