Myometrial Energy Metabolism During Pregnancy and Normal and Dysfunctional Labor

Makkonen, M.

doi:10.3109/00016347709156464

Cited by 8 publications

(3 citation statements)

References 29 publications

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“…LDH 1 and LDH 2 were decreased in severe preeclampsia, as shown by Sammour et al (34). A probable source of release of LDH into the circulation in severe pre-eclampsia is the uterine muscle, as LDH activity increases in the myometrium during pregnancy (10,22,25,33,37). The increased LDH 3 in severe pre-eclampsia is likely to originate from the (M-type) (31).…”

Section: Resultsmentioning

confidence: 87%

Serum Lactic Acid Dehydrogenase and Isoenzymes During Pregnancy and Labor

Makkonen¹,

Penttilä²,

Castrén³

1980

Acta Obstet Gynecol Scand

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Total serum lactic acid dehydrogenase activity (LDH) and the levels of LDH isoenzymes were investigated in 14 women during early pregnancy (8--16th week), in 28 women during late pregnancy (29--37th week), in 73 at term (38--42nd week) and in 27 during labor (38--42nd week). LDH activity was found to be elevated in severe pre-eclampsia and in chronic hypertensive women during pregnancy as well as during normal and dysfunctional labor. No change was established in total serum LDH during normal pregnancy. LDH 1 was increased during late pregnancy and at term. In severe pre-eclampsia and during normal labor it was decreased. LDH 2 was also decreased in severe pre-eclampsia and during dysfunctional labor. LDH 3 was decreased during late pregnancy but increased in severe pre-eclampsia. No change was observed in LDH 4 during pregnancy, or in labor. LDH 5 was increased in normal and dysfunctional labor.

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Section: Resultsmentioning

confidence: 87%

Serum Lactic Acid Dehydrogenase and Isoenzymes During Pregnancy and Labor

Makkonen¹,

Penttilä²,

Castrén³

1980

Acta Obstet Gynecol Scand

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“…Others have reported that LDH anaerobic isoenzyme profile shifts occur in the human myometrium with advancing pregnancy [10,13-15] although it remains unknown when the shift is optimized. In non-pregnant states, estrogenic hormones are known to stimulate LDH activity in non-uterine tissue [35-38] with increased synthesis being predominantly of an anaerobic type [35,37,38].…”

Section: Discussionmentioning

confidence: 99%

“…In myometrial muscle, LDH isoenzymes shift toward a more anaerobic profile as pregnancy advances, speculatively, to better equip the uterus to contend with hypoxic episodes related to labor contractions [10,13-15]. As a result, LDH 3 and/or LDH 4 have been reported to be in greatest concentrations in the pregnant myometrium at term [13,16,17].…”

Section: Introductionmentioning

confidence: 99%

Serum lactate dehydrogenase profile as a retrospective indicator of uterine preparedness for labor: a prospective, observational study

Neal

Lowe

Corwin

2013

BMC Pregnancy Childbirth

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BackgroundLactate dehydrogenase (LDH) isoenzymes are required for adenosine triphosphate production, with each of five different isoenzymes having varying proficiencies in anaerobic versus aerobic environments. With advancing pregnancy, the isoenzyme profile in uterine muscle shifts toward a more anaerobic profile, speculatively to facilitate uterine efficiency during periods of low oxygen that accompany labor contractions. Profile shifting may even occur throughout labor. Maternal serum LDH levels between 24–48 hours following delivery predominantly originate from uterine muscle, reflecting the enzymatic state of the myometrium during labor. Our purpose was to describe serum LDH isoenzymes 24–30 hours post-delivery to determine if cervical dilation rates following labor admission were associated with a particular LDH profile. We also compared differences in post-delivery LDH isoenzyme profiles between women admitted in pre-active versus established active labor.MethodsLow-risk, nulliparous women with spontaneous labor onset were sampled (n = 91). Maternal serum LDH was measured at labor admission and 24–30 hours post-vaginal delivery. Rates of cervical dilation during the first four hours after admission were also measured. Spearman’s rho coefficients were used for association testing and t tests evaluated for group and paired-sample differences.ResultsMore efficient dilation following admission was associated with decreased LDH1 (p = 0.029) and increased LDH3 and LDH4 (p = 0.017 and p = 0.017, respectively) in the post-delivery period. Women admitted in established active labor had higher relative serum levels of LDH3 (t = 2.373; p = 0.023) and LDH4 (t = 2.268; p = 0.029) and lower levels of LDH1 (t = 2.073; p = 0.045) and LDH5 (t = 2.041; p = 0.048) when compared to women admitted in pre-active labor.Despite having similar dilatations at admission (3.4 ± 0.5 and 3.7 ± 0.6 cm, respectively), women admitted in pre-active labor had longer in-hospital labor durations (12.1 ± 4.3 vs. 5.3 ± 1.4 hours; p < 0.001) and were more likely to receive oxytocin augmentation (95.5% vs. 34.8%; p < 0.001).ConclusionsMore efficient cervical dilation following labor admission is associated with a more anaerobic maternal serum LDH profile in the post-delivery period. Since LDH profile shifting may occur throughout labor, watchful patience rather than intervention in earlier labor may allow LDH shifting within the uterus to more fully manifest. This may improve uterine efficiency during labor and decrease rates of oxytocin augmentation, thereby improving birth safety.

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Enzymology of human myometrium: Variations related to the hormonal milieu

Herrmann¹,

Degiampietro

Peheim

et al. 1987

Arch. Gynecol.

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The activities of various enzymes involved in glycolysis, tricarboxylic acid cycle and fatty acid oxidation were assayed in human myometrium. A gradient of the activities from fundal to cervical myometrium was observed. In contrast to studies performed in rodents, cyclic changes of glycolytic enzymes could not be detected. Hydroxyacyl-CoA-dehydrogenase (HAD) activity was higher in secretory phase myometrium and in cases with cystic hyperplasia of the endometrium than in proliferative phase myometrium. In pregnant myometrium, lactate dehydrogenase (LDH) and glycogen phosphorylase (GLP) were increased and in postmenopausal myometrium the activities of phosphofructokinase (PFK), LDH and succinate dehydrogenase (SDH) were decreased as compared to proliferative phase myometrium. We conclude that in the human myometrium, except for HAD, activities of enzymes involved in fuel metabolism are stable throughout the menstrual cycle and that only prolonged hormonal stimulation leads to alterations of some enzyme activities.

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Myometrial Energy Metabolism During Pregnancy and Normal and Dysfunctional Labor

Cited by 8 publications

References 29 publications

Serum Lactic Acid Dehydrogenase and Isoenzymes During Pregnancy and Labor

Serum Lactic Acid Dehydrogenase and Isoenzymes During Pregnancy and Labor

Serum lactate dehydrogenase profile as a retrospective indicator of uterine preparedness for labor: a prospective, observational study

Enzymology of human myometrium: Variations related to the hormonal milieu

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