Amniotic fluid arachidonate lipoxygenase metabolites in preterm labor.

This study was conducted to determine if preterm labor with intact membranes is associated with changes in the amniotic fluid concentrations of arachidonate lipoxygenase metabolites. Amniotic fluid was obtained by transabdominal amniocentesis from 68 women with preterm labor. The patients were classified into three groups according to their response to tocolysis and their amniotic fluid culture results: Group 1 - women with a negative amniotic fluid culture who responded to tocolysis (n = 32); Group 2 - women with a negative culture, but who failed to respond to tocolysis (n = 22); and Group 3 - women with intraamniotic infection (n = 14). The following arachidonate lipoxygenase products were measured by radioimmunoassay: leukotriene B4 (LTB4); leukotriene C4 (LTC4); 12-hydroxyeicosatetraenoic acid (12-HETE); and 15-hydroxyeicosatetraenoic acid (15-HETE). The median concentrations of LTB4 were significantly different among the three study groups (26 pg/ml, 67 pg/ml and 885 pg/ml, respectively, p greater than 0.05). Amniotic fluid concentrations of 12-HETE and LTC4 did not vary among the three study groups. On the other hand, a significant difference in the distribution of amniotic fluid concentrations of 15-HETE was noted only between women with intraamniotic infection (Group 3) and women responding to tocolysis (Group 1). These results indicate that the arachidonate lipoxygenase pathway is activated during the course of preterm labor. Selective changes in the concentrations of the assayed metabolites were noted. Amniotic fluid LTB4 concentrations may be a marker for the patient with preterm labor who is unresponsive to tocolysis.