Endocrinology of parturition

Abstract

The myometrium must remain relatively quiescent during pregnancy to accommodate growth and development of the feto-placental unit, and then must transform into a highly coordinated, strongly contracting organ at the time of labour for successful expulsion of the new born. The control of timing of labour is complex involving interactions between mother, fetus and the placenta. The timely onset of labour and delivery is an important determinant of perinatal outcome. Both preterm birth (delivery before 37 week of gestation) and post term pregnancy (pregnancy continuing beyond 42 weeks) are both associated with a significant increase in perinatal morbidity and mortality. There are multiple paracrine/autocrine events, fetal hormonal changes and overlapping maternal/fetal control mechanisms for the triggering of parturition in women. Our current article reviews the mechanisms for uterine distension and reduced contractions during pregnancy and the parturition cascade responsible for the timely and spontaneous onset of labour at term. It also discusses the mechanisms of preterm labour and post term pregnancy and the clinical implications thereof.

Predicting and Relation between Bio-psychosocial Factors and Type of Childbirth using Decision Tree Method

“…In pregnancy, the placenta is the major source of estrogen secretion and as estrogen increases, the estrogen concentration increases and creates a hyperestrogenic state. Estrogens induce myometrial changes including increased production of prostaglandin (PG) E2 and PG F2α by expression of PG receptor enhancer, increased expression of oxytocin receptor, an adrenergic agonist modulating membrane calcium channels, increased connexin synthesis and gap junction formation in myometrium, responsible enzyme regulation of Muscle contraction, such as light chain kinase myosin and calmodulin, which, with all these changes, results in synchronous uterine contractions (14). Regarding the foregoing and considering the known risk factors of the cesarean section such as old age, overweight, history of cesarean section and failure to perform VBAC, the rules were reviewed by the authors of the article and the rules which were clinically valid and scienti cally available, presented as nal rules.…”

Sodium Hydrogen Exchanger Regulatory Factor-1 (NHERF1) Regulates Fetal Membrane Inflammation

“…Inflammation often involves activation of the master transcription factor nuclear factor kappa B (NF-kB). Infection and other proinflammatory stimuli-induced NF-kB activation is mediated by several factors [ 7 , 8 , 9 , 10 , 11 ]. One of the factors that can influence NF-kB activation in a cell is Na + /H + exchange regulatory factor-1 (NHERF1).…”

The Effect of Anastatica hierochuntica L. Extract on the Histology of Myometrial Cells and Prostaglandin levels (PGE2, PGF2α) in Pregnant Mice

“…The uterine tissue undergoes changes in histological structure that are dynamic based on estrogen levels [18]. Estrogen also increases a series of myometrial changes, including elevated production of the prostaglandins, PGE2 and PGF2α, with a high expression of prostaglandin receptors [19]. Prostaglandins, especially those produced in intrauterine tissue, play a central role in the initiation and development of labor, including myometrial contraction stimulation, metabolism management of the extracellular matrix related to cervical maturation, and upregulation of the fetal HPA-axis [20].…”