title: Influence of misoprostol (PGE1) on amniotic fluid and maternal serum adrenomedullin levels.
abstract: OBJECTIVE
  The purpose of this study was to determine the levels of adrenomedullin (AdM) in amniotic fluid (AF) and maternal serum of misoprostol (PGE1)-induced pregnant women.
  
  
  METHODS
  A total of 40 women were included in the study: 20 were in active labor and were delivered vaginally and a further 20 were not in labor and misoprostol induction was performed. Women who were undergoing labor induction received 50 microg of misoprostol, which was placed in the posterior fornix of the vagina every 4 hrs until the onset of labor. In each patient, maternal plasma and AF samples were collected. Samples of AF were collected by transvaginal route at the time of rupture of the membranes. The labor was at the same stage in both the groups during the sample collection. In all pregnant subjects, maternal blood samples were drawn from the cubital vein at the time of AF sampling. Amniotic fluid and serum AdM concentration was measured by using reverse-phase high-performance liquid chromatography.
  
  
  RESULTS
  Misoprostol-induced pregnant women showed significantly higher AdM concentrations than control pregnant women in AF (79.48 +/- 6.14 pmol/ml versus 21.28 +/- 0.90 pmol/ml, P = 0.000) and maternal serum (88.20 +/- 4.34 pmol/ml versus 29.78 +/- 4.51 pmol/ml, P = 0.000). There was no significant difference between maternal serum and AF-AdM concentrations in misoprostol and control subjects.
  
  
  CONCLUSIONS
  Increased serum and AF-AdM concentrations may be necessary to initiate cervical ripening in misoprostol-induced pregnant women.
authors.affiliation: Department of Obstetrics and Gynecology, Turgut Ozal Medical Center, Inonu University, 44069 Malatya, Turkey. shascalik@inonu.edu.tr
authors.forename: Seyma
authors.initials: S
authors.lastname: Hascalik
authors.forename: Onder
authors.initials: O
authors.lastname: Celik
authors.forename: M Ilker
authors.initials: MI
authors.lastname: Dogru
authors.forename: Arzu
authors.initials: A
authors.lastname: Kocagun Dogru
authors.forename: Esma
authors.initials: E
authors.lastname: Inan
authors.forename: Muhittin
authors.initials: M
authors.lastname: Yurekli
mesh_terms: D000282:Administration, Intravaginal; D053607:Adrenomedullin; D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D010455:Peptides / Q000032:analysis* / Q000097:blood; D011247:Pregnancy
chemical_list: D010120:Oxytocics; D010455:Peptides; D016595:Misoprostol; D053607:Adrenomedullin