Fernandes P A, Boroditsky R S, Roberts G K, Wodzicki A M, McCoshen J A
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba Women's Hospital, Winnipeg, Canada.
J Soc Gynecol Investig. 1999 Jan-Feb;6(1):22-6.
We hypothesize that artificial stimulation of the cervix causes an acute secretion of maternal prolactin (PRL) that mimics PRL secretion during the second stage of human labor.
Eighteen women scheduled for first-trimester therapeutic abortion had a blood sample drawn at the following times: before and after laminaria tent (LT) insertion for cervical ripening, 18-24 hours later upon entry in the procedure room, after LT removal, during instrumental cervical dilatation and uterine evacuation by suction curretage, soon after evacuation, and 1/2 hour and 1 hour after evacuation. Local cervical anesthesia, intravenous analgesics, and sedation were administered before the procedure. Blood serum was assayed for PRL, human chorionic gonadotropin (hCG), and estradiol.
The initial PRL levels were 34 ng/mL +/- 4.2 standard error of the mean (SEM) and did not change after 18-24 hours of LT placement nor after LT removal. However, PRL increased significantly (t = 5.8; P = .00001) over basal levels by 204% +/- 15 at the time of instrumental dilatation and rose to 378% +/- 33 at 1/2 hour postevacuation. After 1 hour, PRL had declined to 173% +/- 10%. Serum levels of estradiol and hCG changed only after evacuation.
Artificial stimulation of the cervix causes an immediate surge in PRL levels. We suggest that the acute increase in pituitary PRL secretion that occurs during the second stage of labor results from a neural signal from the cervix and not from endocrine changes associated with labor.
我们推测，人工刺激宫颈会导致母体催乳素（PRL）急性分泌，这类似于人类分娩第二阶段的PRL分泌。
18名计划进行孕早期治疗性流产的女性在以下时间点采集血样：放置海藻棒（LT）促进宫颈成熟前和后、进入手术室18 - 24小时后、LT取出后、器械扩张宫颈及通过吸刮术清空子宫期间、清空后不久、清空后半小时和1小时。手术前给予局部宫颈麻醉、静脉镇痛剂和镇静剂。检测血清中的PRL、人绒毛膜促性腺激素（hCG）和雌二醇。
初始PRL水平为34 ng/mL ± 4.2平均标准误差（SEM），放置LT 18 - 24小时后及LT取出后均未改变。然而，在器械扩张宫颈时，PRL较基础水平显著升高（t = 5.8；P = 0.00001），升高了204% ± 15，在清空后半小时升至378% ± 33。1小时后，PRL降至173% ± 10%。雌二醇和hCG血清水平仅在清空后发生变化。
人工刺激宫颈会导致PRL水平立即激增。我们认为，分娩第二阶段垂体PRL分泌的急性增加是由来自宫颈的神经信号引起的，而非与分娩相关的内分泌变化所致。
