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  • Title: Physical and biomechanical characteristics of rat cervical ripening are not consistent with increased collagenase activity.
    Author: Buhimschi IA, Dussably L, Buhimschi CS, Ahmed A, Weiner CP.
    Journal: Am J Obstet Gynecol; 2004 Nov; 191(5):1695-704. PubMed ID: 15547544.
    Abstract:
    OBJECTIVE: The cervix progressively softens during pregnancy to allow stretch without rupture in labor. Cervical softening is the product of complex modifications that include increased proteoglycan-to-collagen ratio, increased hyaluronic acid and water content, and breakdown of collagen by matrix metalloproteases. The relative contribution of collagen breakdown to cervical ripening is unclear. We sought to identify, discriminate, and quantify the physical characteristics of rat cervix during pregnancy, labor, and both before and after exposure to either prostaglandin (PGE(2)) or the collagenolytic enzyme matrix metalloprotease-1 (MMP-1). STUDY DESIGN: Cervices were collected from nonpregnant rats in diestrus (n=4) and pregnant rats on d10 (n=4), d16 (n=11), d20 (n=5), and d22 (term) nonlabor (NL: n=4) and d22 in term labor (TL: n=7). Cervices were also collected from a separate group in preterm labor induced by RU486 (PTL: n=10). The effect of PGE(2) on cervical characteristics was determined after intravaginal placement of PGE(2) gel (0.5 mg PGE(2): n=3) or placebo metylcellulose gel (CRL(PG) n=6) for 20 hours before euthanasia on d16. The effect of collagen was determined by incubating in vitro cervices from untreated d16 rats with (MMP-1: n=3) and without (CRL(MMP): n=7) activated collagenase before tensile testing. Tensile properties were quantitated by using Shimadzu EZ-test instrumentation (Shimadzu North America, Columbia, Md) with a stretching regimen that mimicked labor contractions while recording the force opposed by the tissue. Parameters such as the slope (a measure of stiffness), yield point (YP; moment the tissue changes its proprieties from elastic to plastic), and break point (BP; a measure of tissue strength) were recorded and analyzed. The plateau was defined as the phase after YP but before BP. RESULTS: Compared with d16, cervical extensibility increased significantly by d20 (slope d16: 0.41 +/- 0.03 N/mm vs d20: 0.19 +/- 0.05 N/mm, P < .01), and during both PTL (slope: 0.17 +/- 0.03 N/mm) and TL (slope: 0.11 +/- 0.02 N/mm). This increase was mimicked by PGE(2) (slope PGE(2): 0.24 +/- 0.03 vs CRL(PG): 0.40 +/- 0.05 N/mm, P=.04), but not by collagenase (slope MMP-1: 0.35 +/- 0.02 vs CRL(MMP): 0.38 +/- 0.05 N/mm, P>.05). YP was significantly reduced as pregnancy advanced, whereas BP increased, suggesting both increased plasticity (compliance) and strength. However, the plateau length increased 3-fold both by d20 and after PGE(2). In contrast, the addition of MMP-1 reduced the plateau. BP occurred significantly earlier in collagenase-treated tissues, but later in PTL-, TL-, and PGE(2)-treated cervices. CONCLUSION: The changes in physical properties of the rat cervix during physiologic ripening are similar to those induced by PGE(2) and RU486, and consist of increased extensibility, compliance, and strength. These changes cannot be attributed to increased collagenase activity, which would decrease tissue compliance and strength.
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