Prostaglandin endoperoxide H synthase mRNA expression in the fetal membranes correlates with fetal fibronectin concentration in the cervico-vaginal fluids at term: evidence of enzyme induction before the onset of labour.

OBJECTIVE To determine the relationship of prostaglandin endoperoxide H synthase (PGHS) expression in the gestational tissues and fetal fibronectin in cervico-vaginal fluids before the onset of labour at term. DESIGN Cross-sectional, observational study. SAMPLES Amnion, chorion laeve and decidua were collected from 24 term pregnant women following elective caesarean section. Samples of cervico-vaginal secretions were obtained from the same women immediately before caesarean section. METHODS PGHS-1 and PGHS-2 mRNA levels in tissues were determined by specific ribonuclease protection assays. Fetal fibronectin concentrations in the cervico-vaginal fluids were measured by enzyme-linked immunosorbent assay. The abundance of PGHS mRNA was compared between groups of patients with the same mean gestational age but different cervico-vaginal fetal fibronectin levels. Linear regression analysis was used to determine the association between PGHS levels and fetal fibronectin. RESULTS Two groups of women were identified who had significantly different fetal fibronectin values but the same gestational ages. The group with the higher fetal fibronectin concentrations had significantly higher PGHS- 1 and PGHS-2 mRNA levels in the chorion laeve and higher PGHS-2 mRNA levels in the amnion, than the group with lower fetal fibronectin concentrations. PGHS- 1 and PGHS-2 mRNA levels in the chorion laeve and PGHS-2 mRNA in the amnion showed an overall significant association with fetal fibronectin levels. CONCLUSIONS High concentrations of fetal fibronectin in cervico-vaginal secretions before the onset of spontaneous labour at term are associated with high levels of PGHS-2 mRNA in the chorion laeve and the amnion and of PGHS- 1 mRNA in the chorion laeve. Increased expression of PGHS in these tissues may therefore be involved in the events leading to term birth.