Physiology and Pathology of Contractility of the Myometrium

Koutras, Antonios; Fasoulakis, Zacharias; Syllaios, Athanasios; Garmpis, Nikolaos; Diakosavvas, Michail; Pagkalos, Athanasios; Ntounis, Thomas; Kontomanolis, Emmanuel N

doi:10.21873/invivo.12392

Cited by 10 publications

(6 citation statements)

References 59 publications

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“…Interestingly, women with failed labor induction show higher leptin concentrations than women with successful labor induction to such a degree that leptin represents an independent failed labor induction predictor [77]. This inhibitory effect of leptin on myometrial contractions may also be associated with PPH since contraction of the myometrium is the main mechanism by which bleeding is stopped after delivery [78].…”

Section: Leptinmentioning

confidence: 99%

Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines

Valencia-Ortega,

Solis-Paredes,

Saucedo

et al. 2023

IJMS

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There is a high frequency of overweight and obesity in women of reproductive age. Women who start pregnancy with overweight or obesity have an increased risk of developing maternal obstetric complications such as gestational hypertension, pre-eclampsia, gestational diabetes mellitus, postpartum hemorrhage, and requiring C-section to resolve the pregnancy with a higher risk of C-section surgical site infection. Excessive weight in pregnancy is characterized by dysregulation of adipokines, the functions of which partly explain the predisposition of pregnant women with overweight or obesity to these maternal obstetric complications. This review compiles, organizes, and analyzes the most recent studies on adipokines in pregnant women with excess weight and the potential pathophysiological mechanisms favoring the development of maternal pregnancy complications.

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Section: Leptinmentioning

confidence: 99%

Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines

Valencia-Ortega,

Solis-Paredes,

Saucedo

et al. 2023

IJMS

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“…The detailed cellular-level physiology of myometrial contraction is beyond the scope of this review; however, at its most basic, sodium ion influx followed by increased intracellular calcium from both intracellular and extracellular sources results in myosin light-chain kinase activity and smooth muscle contraction [12]. Uterotonic agents work via different mechanisms to increase intracellular calcium and promote myometrial contractility [12].…”

Section: Pathophysiologymentioning

confidence: 99%

“…These uterotonic therapies, detailed in Fig. 2, reduce PPH from uterine atony by 40−50% [1 ▪ ,2 ▪ ,12].…”

Section: Treatmentmentioning

confidence: 99%

Uterine atony

Miller

Ansari

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewPostpartum hemorrhage (PPH) is the leading preventable cause of maternal morbidity and mortality worldwide. Uterine atony is identified as the underlying etiology in up to 80% of PPH. This serves as a contemporary review of the epidemiology, risk factors, pathophysiology, and treatment of uterine atony.Recent findingsRates of postpartum hemorrhage continue to rise worldwide with the largest fraction attributed to uterine atony. A simple 0–10 numerical rating score for uterine tone was recently validated for use during cesarean delivery and may allow for more standardized assessment in clinical and research settings. The optimal prophylactic dose of oxytocin differs depending on the patient population, but less than 5 units and as low as a fraction of one unit is needed for PPH prevention, with an increased requirements within that range for cesarean birth, those on magnesium, and advanced maternal age. Carbetocin is an appropriate alternative to oxytocin. Misoprostol shows limited to no efficacy for uterine atony in recent studies. Several uncontrolled case studies demonstrate novel mechanical and surgical interventions for treating uterine atony.SummaryThere is a critical, unmet need for contemporary, controlled studies to address the increasing threat of atonic PPH.

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“…S. Mashiach et al (2002) описали успішне ведення 4 шийних вагітностей за допомогою шва Широдкар, і в одному з цих випадків одночасно із шийковою вагітністю розвивалася нормальна маткова вагітність, яка закінчилась пологами на 39 тижні вагітності здоровим новонародженим [19]. Cеркляж Широдкара був обраний замість шва МакДональда через його розміщення у вищому місці на шийці матки, щоб максимально зашити гестаційний мішок і таким чином досягти кращого гемостазу [13,16,19].…”

Section: результати обговоренняunclassified

Ectopic pregnancy of cervical localization: modern aspects of treatment

Lovkina¹,

Kosianenko²,

Klivak³

et al. 2022

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. A review of the scientific literature on the problem of diagnosis and modern methods of treatment of cervical pregnancy is presented. Ectopic pregnancy (ectopic pregnancy) is a condition in which the implantation and development of a fertilized egg takes place outside the uterine cavity and is one of the threatening conditions for life and reproductive health of women. Cases of cervical pregnancy occur with a frequency between 1:8 600 and 1:12 400 cases of the total number of all pregnancies and less than 1% of the number of ectopic pregnancies. Suspicion of a diagnosis of “cervical pregnancy” is an indication for immediate hospitalization of the woman in a gynecological hospital, a thorough examination and selection of treatment, because this pathology can provoke massive bleeding in the first trimester of pregnancy. In the practice of obstetrician-gynecologist for a long time there was one method of treatment of this pathology – extirpation of the uterus. To date, there are conservative and surgical treatments, that we will cover in this article. We conducted a systematic review and analysis of relevant literature sources, which have been published in the vast majority over the past 10 years (2012-2022), on modern methods of diagnosis and treatment of cervical pregnancy. The search was conducted in search databases PubMed, Google Scholar, Cochrane Library, Web of Science. The following search terms were used in the work: “cervical pregnancy”, “ectopic pregnancy”. It was found that the problem of treatment of cervical pregnancy remains relevant today, because there is no clear opinion on the best method of treatment. The decision to use one or another method is left to the attending physician, who must adequately assess the patient's condition, obstetric situation and possible options for prescribing appropriate treatment, the available methods were justified.

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Physiology and Pathology of Contractility of the Myometrium

Cited by 10 publications

References 59 publications

Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines

Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines

Uterine atony

Ectopic pregnancy of cervical localization: modern aspects of treatment

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