Purinergic, P2X3 positive cells in amniotic membranes

Abstract

We appreciate the thoughtful comments of Dr Worley and his dedication to the care of this special group of children that we set out to help by exploring the possibility of fetal surgery for myelomeningocele more than 20 years ago. To address his concerns specifically:

Physiological approaches to reducing blood loss during cesarean delivery

“…"Slow" decompression of the uterus reduces the "stretch" of the amniotic membranes, including the recently described layer of purinergic P2X3 "stretch" receptors in the maternal chorion (Figure ), whose activation may enable depolarization and contraction of the myometrium. 2 Slow decompression of the uterus may provide time for "purinergic mechanosensory transduction" to convert the mechanical stimulus ("loss of stretch") into spontaneous uterine activity to assist with delivery and hemostasis. 3,4 Rapid delivery of the neonate may not allow time for these physiological processes and may require further pharmacologic support to control any postpartum hemorrhage.…”