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[Endocrine, paracrine and electrophysiologic regulation of human labor]
Snjezana Skrablin1, Drzislav Kalafatić, Trpimir Goluza
1Klinika za zenske bolesti i porode KBC-a Zagreb i Medicinskog fakulteta Sveucilista u Zagrebu, Petrova 13, 10000 Zagreb.
The problem of labor and delivery, either at term or occurring prematurely, are among the greatest problems facing physicians nowadays. The understanding of the process of preparation and initiation of active labor is of utmost importance. Currently, the clinical methods to assess the changes of the uterus and cervix are still subjective, inaccurate and crude. Fortunately, a noninvasive method of transabdominal uterine muscle electrical activity analysis (electromiography, EMG) is digitalized and standardized in recognizing uterine contractility, and biochemical changes, as well as ultrasound and fluorescent methods, are emerging to estimate cervical preparation prior to active labor. Studies in humans indicate that uterine and cervical function an be accurately monitored during pregnancy and during the preparation for labor. In the review article all aspects of uterine muscle and uterine cervix architecture, preparation for labor and control of these processes are presented. The development of new methods of diagnosis for the patient in labor will improve our ability to diagnose preterm labor early enough to undertake all kinds of scientifically based methods and strategies specifically for the management of this condition.
The problem of labor and delivery, either at term or occurring prematurely, are among the greatest problems facing physicians nowadays. The understanding of the process of preparation and initiation of active labor is of utmost importance. Currently, the clinical methods to assess the changes of the uterus and cervix are still subjective, inaccurate and crude. Fortunately, a noninvasive method of transabdominal uterine muscle electrical activity analysis (electromiography, EMG) is digitalized and standardized in recognizing uterine contractility, and biochemical changes, as well as ultrasound and fluorescent methods, are emerging to estimate cervical preparation prior to active labor. Studies in humans indicate that uterine and cervical function an be accurately monitored during pregnancy and during the preparation for labor. In the review article all aspects of uterine muscle and uterine cervix architecture, preparation for labor and control of these processes are presented. The development of new methods of diagnosis for the patient in labor will improve our ability to diagnose preterm labor early enough to undertake all kinds of scientifically based methods and strategies specifically for the management of this condition.