Cervicovaginal matrix metalloproteinase-9 and cervical ripening in human term parturition.
OBJECTIVE
To investigate the changes of matrix metalloproteinase-9 (MMP-9) in cervicovaginal fluid during pregnancy and its association with parturition.


METHODS
A prospective study was conducted on nulliparous women between 16 and 42 weeks with normal singleton pregnancies in the following categories: (1) preterm control (n=39); (2) term labor induction without labor or rupture of membranes (n=68); (3) term spontaneous labor with intact membranes (n=42); (4) term premature rupture of membranes (n=24). The MMP-9 concentration in the cervicovaginal fluid was measured by immunoassay.


RESULTS
(1) Cervicovaginal MMP-9 did not change significantly with advancing gestation until 37 weeks, and significantly increased after 37 weeks. (2) Cervicovaginal MMP-9 levels were similar in women with no labor, spontaneous labor, and premature rupture of membranes at term. (3) For the induced labor group, a high Bishop score (>or=4) was significantly correlated with cervicovaginal MMP-9. However, an elevated cervicovaginal MMP-9 did not predict achieving active phase of labor or vaginal delivery after labor induction.


CONCLUSIONS
Cervicovaginal MMP-9 correlated with cervical ripening before labor at term. However, cervicovaginal MMP-9 did not change with spontaneous labor or rupture of membranes at term and did not predict success of labor induction.
Choi
Suk-Joo
SJ
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Jung
Kyung-Lan
KL
Oh
Soo-young
SY
Kim
Jong-Hwa
JH
Roh
Cheong-Rae
CR
D000328:Adult; D001826:Body Fluids / Q000201:enzymology; D020070:Cervical Ripening / Q000502:physiology*; D002584:Cervix Uteri / Q000201:enzymology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000201:enzymology; D005865:Gestational Age; D006801:Humans; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism*; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D014621:Vagina / Q000201:enzymology
D020780:Matrix Metalloproteinase 9