Amniotic fluid adhesion molecules during parturition at term

AIMS: During term parturition a constant elevation of intercellular adhesion molecule (ICAM-1) as well as increases of endothelial leukocyte adhesion molecule (ELAM-1) and vascular cell adhesion molecule (VCAM-1) in the lower uterine segment and of ICAM-1 in fetal membranes were observed. We examined ELAM-1, ICAM-1 and VCAM-1 during normal term parturition to find out whether amniotic fluid adhesion molecules change accordingly. METHODS: Amniotic fluid specimens of 35 patients undergoing cesarean section at term with various stages of cervical dilatation (<2 cm, n=11; 2-<4 cm, n=10; 4-6 cm, n=6; >6 cm, n=8) and different durations of labor (0 h, n=11; >0 h, n=24) were examined for ELAM-1, ICAM-1 and VCAM-1 by enzyme immunoassay. For statistical analysis one-way ANOVA (cervical dilatation) and unpaired t-test (duration of labor) were used (P<0.05). RESULTS: Neither ELAM-1 nor VCAM-1 correlated with cervical dilatation or with the duration of labor. ICAM-1 showed a tendency to decline with the last phase of cervical dilatation (P=0.06) and a significant decline with labor (P=0.046). CONCLUSIONS: In contrast to adhesion molecules in the lower uterine segment amniotic fluid adhesion molecules ELAM-1 and VCAM-1 do not rise significantly during parturition. The decline of ICAM-1 may be due to a transfer to other compartments (i.e., lower uterine segment or retroplacental blood) thereby contributing to labor and cervical dilatation.