Prostaglandin E production by the fetal membranes in unexplained preterm labour and preterm labour associated with chorioamnionitis

Abstract

Summary The production of prostaglandin E (PGE) by amnion, choriodecidua and placenta was measured in 45 women delivered after spontaneous preterm labour, in 10 women delivered electively preterm, in 30 women at elective caesarean section at term, and in 28 women after spontaneous labour at term. In the preterm labour group 24 women had normal placental histology, and gestational age was 34 (31–36) weeks (median and range); 18 women had evidence of chorioamnionitis and gestational age was significantly shorter, 30 (24–36) weeks; three other patients had placental abruption. In the absence of inflammatory infiltration of these tissues the highest PGE output (fmol/mg dry weight/2 h) was found after labour at term and the lowest after uncomplicated preterm labour: 2640 (360–15 580) (median and range) compared with 1414 (164–11 045) in amnion, 677 (100–3245) compared with 308 (39–1086) in choriodecidua, and 1200 (520–3022) compared with 578 (150–1859) in placenta, respectively. Tissues showing chorioamnionitis produced much higher outputs of PGE from amnion (12278, 1799–82 617) and from choriodecidua (1018, 216–11 768), but not from placenta (616, 89–4131). Chorioamnionitis seems to cause very early preterm labour by increasing PG production in the amnion and choriodecidua.