Cervical Collagen

TLDR

The study compared cervical biopsies from three groups: women with favorable cervix and spontaneous labor, women with unfavorable cervix primed with 0.5 mg prostaglandin E2 gel, and women with unfavorable cervix who delivered spontaneously. The study found that women with unfavorable cervix who delivered spontaneously had significantly higher total and nonextractable cervical collagen and longer dilation times, while prostaglandin E2 treatment increased collagenolytic activity, indicating that cervical collagen regulates labor and that prostaglandin E2 mimics spontaneous priming. Obstet Gynecol 67:633, 1986.

Abstract

This study provides the first clear evidence of a close correlation between the biochemical composition of the cervix and the clinical course of delivery in terms of cervical dilatation. Cervical biopsy specimens were obtained from three groups of patients: Group A, ten women with favorable cervix and spontaneous labor; group B, 12 women with unfavorable cervix given 0.5 mg prostaglandin E2 in gel intracervically for cervical priming and induction of labor; and group C, five women with unfavorable cervix and spontaneous labor. Cervical dilatation time was significantly longer (18 hours) for women in group C compared with women in group A (6.7 hours) and in group B (5.0 hours;P < .001). The total amount of cervical collagen was significantly higher in women in group C at 8.58μg/mg compared with 6.7μg/mg in women in group A and 5.47μg/mg in prostaglandin E2-treated women in group B. The amount of nonextractable collagen also was significantly higher in women in group C, 23.6% compared with 11.3% in group A, and 12.4% in group B (P < .01). The collagenolytic activity was significantly increased in cervical biopsy specimens from prostaglandin E2 gel-treated patients—520 U/100 mg wet weight compared with 380 U/100 mg wet weight in untreated patients in group A (P < .05). From these results it is concluded that cervical collagen is an important regulator of cervical function in late pregnancy and term labor; that prostaglandin E2 is involved in cervical priming, initiation, and progress of term labor; and that intracervical application of prostaglandin E2 seems to mimic spontaneous cervical priming in both clinical and biochemical terms. (Obstet Gynecol 67:633, 1986)