Low molecular weight heparin stimulates myometrial contractility and cervical remodeling in vitro

Gunvor Ekman-Ordeberg, Margareta Hellgren, Anna Åkerud, Eva Andersson, Aurelija Dubicke, Maria Sennstrom, Birgitta Bystrom, Gerasimos Tzortzatos, Maria Gomez, Mans Edlund, Ulf Lindahl, Anders Malmström

Research output: Contribution to journalArticlepeer-review

26 Citations (SciVal)

Abstract

Objectives. The low molecular weight heparin, Dalteparin, shortens human labor time. The aim of this study was to investigate if the mechanism behind this effect involves myometrial contractility and cervical ripening and if the anticoagulative activity is necessary for its effect. Design. Experimental in vitro study. Setting. Lund University and Karolinska Institute, Sweden. Methods. The effect of low molecular weight heparins with or without anticoagulative properties on myometrial contractility was measured in vitro on smooth muscle strips from biopsies obtained at elective cesarean sections. The effects on cervical ripening were assessed in cervical fibroblasts cultured from explants of cervical biopsies obtained at delivery. Main outcome measures. Mean force and number of contractions in uterine smooth muscle strips and interleukin-8 (IL-8) secretion in cervical fibroblasts. Results. Myometrial smooth muscle strips pretreated with low molecular weight heparins showed increased contractile activity compared to untreated smooth muscle strips. Secretion of IL-8 from cultured cervical fibroblasts was significantly increased after treatment with low molecular weight heparin. Both these effects were independent of anticoagulative activity of the low molecular weight heparin. Conclusions. A possible underlying mechanism for the shortened labor time after low molecular weight heparin treatment is enhanced myometrial contractility and an increased IL-8 secretion in cervical fibroblast, mimicking the final cervical ripening in vivo. Our data support the notion that anticoagulant activity is not required to promote labor.
Original languageEnglish
Pages (from-to)984-989
JournalActa Obstetricia et Gynecologica Scandinavica
Volume88
Issue number9
DOIs
Publication statusPublished - 2009

Subject classification (UKÄ)

  • Obstetrics, Gynecology and Reproductive Medicine

Keywords

  • Low molecular weight heparin
  • cervical ripening
  • myometrial
  • contractility

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