Download PDF
Am J Perinatol 2012; 29(09): 699-704
DOI: 10.1055/s-0032-1314891
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

In vitro Myometrial Contractility Profiles of Different Pharmacological Agents Used for Induction of Labor

Giuseppe Chioss
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Maged M. Costantine
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Egle Bytautiene
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Ancizar Betancourt
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Gary D.V. Hankins
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
George R. Saade
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Monica Longo
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
› Author Affiliations
Further Information

Publication History

01 January 2012

01 February 2012

Publication Date:
29 May 2012 (online)

Also available at
    Permissions and Reprints

Abstract

Objective To investigate the effects of different pharmacological induction agents on myometrial contractility.

Study Design Myometrial biopsies were obtained from 13 term nonlaboring women undergoing scheduled cesarean delivery. Tissue strips were suspended in organ chambers for isometric tension recording. The effects of cumulative doses (10−10 mol/L to 10−5 mol/L) of prostaglandin E1 (PGE1), E2 (PGE2), and oxytocin on spontaneous uterine contractility were determined. Areas under the contraction curve were compared using one-way analysis of variance on ranks with Dunn post hoc test.

Results Oxytocin-induced myometrial contractility was superior to PGE1, PGE2, and time controls (CTR) at all the concentrations tested. When only prostaglandins were compared with CTR, PGE1 10−5 mol/L increased myometrial contractility, and PGE2 had no effects.

Conclusion Oxytocin and prostaglandins have different effects on myometrial contractility accounting for different mechanisms of action and side effects. The increased uterine contractility observed with PGE1 as compared with PGE2 can contribute to explain the higher success of vaginal delivery.

Keywords

prostaglandin E1 - prostaglandin E2 - oxytocin - uterine contractility - organ chamber
 

  • References

  • 1 ACOG Committee on Practice Bulletins – Obstetrics. ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol 2009; 114 (2 Pt 1) 386-397
    CrossrefPubMedSearch in Google Scholar
  • 2 Martin JA, Hamilton BE, Sutton PD. Births: final data for 2006: National vital statistics reports; vol. 57; No. 7. Hyattsville, MD: National Center for Health Statistics; 2009
    Search in Google Scholar
  • 3 Resnik JL, Resnik R. Post term pregnancy. In: Creasy RK, Resnik R, Iams JD, Lockwood JD, Moore TM, eds. Creasy & Resnik's Maternal-Fetal Medicine, Principles and Practice. 6th ed. Philadelphia: Saunders Elsevier; 2009
    Search in Google Scholar
  • 4 Xenakis EM, Piper JM, Conway DL, Langer O. Induction of labor in the nineties: conquering the unfavorable cervix. Obstet Gynecol 1997; 90: 235-239
    CrossrefPubMedSearch in Google Scholar
  • 5 Justus Hofmeyr G. Induction of labour with an unfavourable cervix. Best Pract Res Clin Obstet Gynaecol 2003; 17: 777-794
    CrossrefPubMedSearch in Google Scholar
  • 6 Royal College of Obstetricians and Gynaecologists. Induction of Labour. Guideline; No. 9. London, UK: RCOG Press; 2001
    Search in Google Scholar
  • 7 Stjernholm YM, Sahlin L, Eriksson HA, Byström BE, Stenlund PM, Ekman GE. Cervical ripening after treatment with prostaglandin E2 or antiprogestin (RU486). Possible mechanisms in relation to gonadal steroids. Eur J Obstet Gynecol Reprod Biol 1999; 84: 83-88
    CrossrefPubMedSearch in Google Scholar
  • 8 Ji H, Dailey TL, Long V, Chien EK. Prostaglandin E2-regulated cervical ripening: analysis of proteoglycan expression in the rat cervix. Am J Obstet Gynecol 2008; 198: 536 , e1–e7
    PubMedSearch in Google Scholar
  • 9 Sahlin L, Stjernholm-Vladic Y, Roos N, Masironi B, Ekman-Ordeberg G. Impaired leukocyte influx in cervix of postterm women not responding to prostaglandin priming. Reprod Biol Endocrinol 2008; 6: 36
    CrossrefPubMedSearch in Google Scholar
  • 10 Mercer B, Pilgrim P, Sibai B. Labor induction with continuous low-dose oxytocin infusion: a randomized trial. Obstet Gynecol 1991; 77: 659-663
    PubMedSearch in Google Scholar
  • 11 Kelly AJ, Malik S, Smith L, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev 2009; (4) CD003101
    PubMedSearch in Google Scholar
  • 12 Hofmeyr GJ, Gülmezoglu AM, Pileggi C. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev 2010; 10: CD000941
    PubMedSearch in Google Scholar
  • 13 Fonseca L, Wood HC, Lucas MJ , et al. Randomized trial of preinduction cervical ripening: misoprostol vs oxytocin. Am J Obstet Gynecol 2008; 199: 305 , e1–e5
    PubMedSearch in Google Scholar
  • 14 Alfirevic Z, Kelly AJ, Dowswell T. Intravenous oxytocin alone for cervical ripening and induction of labour. Cochrane Database Syst Rev 2009; (4) CD003246
    PubMedSearch in Google Scholar
  • 15 Shojo H, Kaneko Y. Characterization and expression of oxytocin and the oxytocin receptor. Mol Genet Metab 2000; 71: 552-558
    CrossrefPubMedSearch in Google Scholar
  • 16 Popat A, Crankshaw DJ. Variable responses to prostaglandin E(2) in human non-pregnant myometrium. Eur J Pharmacol 2001; 416: 145-152
    CrossrefPubMedSearch in Google Scholar
  • 17 Word RA, Kamm KE, Casey ML. Contractile effects of prostaglandins, oxytocin, and endothelin-1 in human myometrium in vitro: refractoriness of myometrial tissue of pregnant women to prostaglandins E2 and F2 alpha. J Clin Endocrinol Metab 1992; 75: 1027-1032
    CrossrefPubMedSearch in Google Scholar
  • 18 Wikland M, Lindblom B, Wilhelmsson L, Wiqvist N. Oxytocin, prostaglandins, and contractility of the human uterus at term pregnancy. Acta Obstet Gynecol Scand 1982; 61: 467-472
    CrossrefPubMedSearch in Google Scholar
  • 19 Gordon-Wright AP, Elder MG. Effect of prostaglandin E2 and its metabolites on lower segment myometrium in vitro. Eur J Obstet Gynecol Reprod Biol 1980; 10: 297-302
    CrossrefPubMedSearch in Google Scholar
  • 20 Cornely M, Klappstein I, Schüssler J, Rücker W, Schönhöfer PS. [Plasma levels of PGE2, PGA2 and PGF2 alpha during spontaneous labour]. Z Geburtshilfe Perinatol 1979; 183: 223-228
    PubMedSearch in Google Scholar
  • 21 Goharkhay N, Stanczyk FZ, Gentzschein E, Wing DA. Plasma prostaglandin E(2) metabolite levels during labor induction with a sustained-release prostaglandin E(2) vaginal insert. J Soc Gynecol Investig 2000; 7: 338-342
    CrossrefPubMedSearch in Google Scholar
  • 22 Izumi H, Garfield RE, Morishita F, Shirakawa K. Some mechanical properties of skinned fibres of pregnant human myometrium. Eur J Obstet Gynecol Reprod Biol 1994; 56: 55-62
    CrossrefPubMedSearch in Google Scholar
  • 23 Austin SC, Sanchez-Ramos L, Adair CD. Labor induction with intravaginal misoprostol compared with the dinoprostone vaginal insert: a systematic review and metaanalysis. Am J Obstet Gynecol 2010; 202: 624 , e1–e9
    PubMedSearch in Google Scholar
  • 24 American College of Obstetricians and Gynecologists. Practice bulletin no. 116: Management of intrapartum fetal heart rate tracings. Obstet Gynecol 2010; 116: 1232-1240
    CrossrefPubMedSearch in Google Scholar