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Objective To determine whether circulating levels of cell adhesion molecules, markers of endothelial damage and leucocyte activation, were increased in pre‐eclampsia. Design Serum was prepared from peripheral venous blood and stored at –70°C. The cell adhesion molecules, VCAM‐1, E‐Selectin and ICAM‐1, were measured by ELISA. Setting Department of Obstetrics and Gynaecology, Royal Infirmary, Glasgow. Subjects Sixteen primigravid women with pre‐eclampsia were recruited for the study. The pre‐eclampsia group were compared with 18 healthy primigravid women with uncomplicated pregnancies. Results The pre‐eclamptic group had significantly higher serum levels of the cell adhesion molecule VCAM‐1 (t= 3.673; P < 0.001). There were no significant differences in the adhesion molecules ICAM‐1 or E‐Selectin. Conclusions Endothelial damage and dysfunction are common to all the pathological features of pre‐eclampsia. This study shows that concentrations of cell adhesion molecules, which indicate leucocyte‐endothelial attachment and activation, are elevated in the serum of patients with pre‐eclampsia. Such increases in soluble circulating cell adhesion molecules may reflect increased expression of these molecules on the endothelium and thereby explain the mechanism for leucocyte activation in pre‐eclampsia.

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Nitric oxide (NO) has been proposed as a mediator of cervical ripening. We investigated the expression, using Western blotting, and localization, using immunohistochemistry, of the nitric oxide synthase (NOS) enzymes, inducible NOS (iNOS), endothelial NOS (eNOS) and neuronal NOS (bNOS) in the human cervix during pregnancy and parturition. Cervical biopsies were obtained from non-pregnant women, women in the first trimester of pregnancy, and pregnant women at term before and after the onset of labour. Each of the NOS isoforms was localized in the cervices of both non-pregnant and pregnant subjects using immunohistochemistry. iNOS expression was significantly greater in early pregnancy compared with the non-pregnant state (P: < 0.005). iNOS expression was up-regulated further in samples obtained in the third trimester compared with the first trimester. bNOS expression was greater in samples from the first trimester of pregnancy than in non-pregnant samples (P: < 0. 005), but showed no additional increase in late pregnancy or with the onset of labour. eNOS expression was increased in samples obtained in the third trimester both before (P: = 0.002) and after the onset of labour (P: < 0.002) when compared with non-pregnant samples. The increased expression of NOS isoforms in late pregnancy supports the hypothesis that NO is involved in the process of cervical ripening.