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[Biochemical and hormonal regulation of uterine contractility: clinical applications to medicinal tocolysis]
1Clinique obstétricale et laboratoire de recherches, Hôpital universitaire Brugmann, Université libre de Bruxelles.
Preterm delivery occurs in 5-10% of live births. Preterm labour is the leading cause of perinatal mortality and morbidity. It accounts for one third of perinatal deaths. Clinicians stay faced to the use of tocolytic therapy carrying the risks of side-effects for the fetus and the mother. The regulation of uterine contractility through myosin phospho-dephosphorylation is controlled by second messenger system (Calcium, cAMP). Furthermore, some hormones seem to control the development and the regression of gap junctions which promote synchronous muscle activity by allowing electrical and mechanical coupling of the cells within different regions of the uterus. Understanding of these cellular regulatory processes is the rationale to the choice of tocolytic drugs actually available. It sounds to be a further step to innovative approaches to tocolytic therapy without or with less significant side effects.
Preterm delivery occurs in 5-10% of live births. Preterm labour is the leading cause of perinatal mortality and morbidity. It accounts for one third of perinatal deaths. Clinicians stay faced to the use of tocolytic therapy carrying the risks of side-effects for the fetus and the mother. The regulation of uterine contractility through myosin phospho-dephosphorylation is controlled by second messenger system (Calcium, cAMP). Furthermore, some hormones seem to control the development and the regression of gap junctions which promote synchronous muscle activity by allowing electrical and mechanical coupling of the cells within different regions of the uterus. Understanding of these cellular regulatory processes is the rationale to the choice of tocolytic drugs actually available. It sounds to be a further step to innovative approaches to tocolytic therapy without or with less significant side effects.