Amniotic fluid adhesion molecules during parturition at term

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.

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).

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).

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.