Human Reproduction vol.10 no.9 pp.2453-2455, 1995 Changes in the coelomic fluid composition following two different methods of cervical ripening

3To whom correspondence should be addressed We have evaluated the changes in maternal serum and coelomic fluid biochemical composition following two dif-ferent methods of cervical ripening, i.e. mechanical and biochemical. Each study group included 20 women between 8 and 12 weeks of gestation who were requesting termina-tion for psychosocial reasons. In the first group, a 3 mm hypan (synthetic hygroscopic dilator) was inserted into the cervix 12 h preoperatively. In the second group, two 1 mg pessaries of gemeprost (prostaglandin analogue) were inserted into the posterior fornix 6 and 2 h preoperatively. Coelomic fluid and maternal serum were obtained at the time of the surgical procedure and assayed for urea, total protein, potassium, sodium, human chorionic gonadotro-phin (HCG) and ct-fetoprotein (AFP). Significantly higher coelomic fluid sodium (t = 4.72; P = 0.029) and significantly higher maternal serum AFP (t = 13.21; P < 0.001) concentrations were observed after gemeprost than after hypan. There was no difference in the concentration of potassium, urea, total protein and HCG between the two groups. These findings indicate that prostaglandin ana-logues, when used for cervical ripening, provoke a break-down of the placental barrier resulting in an increase in AFP molecules transferred from the fetal fluid compart-ments into the maternal circulation. The results also suggest that these drugs increase the placental permeability to sodium with a secondary accumulation of this ion in the coelomic fluid. Key words: abortion/coelomic fluid/early pregnancy/a-feto-protein/first trimeste