Labour is characterized by spontaneous uterine contractions that result in the delivery of the fetus and placenta. The onset of labour involves several key changes, including cervical effacement and dilation as well as the formation of the amniotic sac. Various hormonal and mechanical factors contribute to labour onset, such as an increase in oxytocin receptors and prostaglandins in the uterus and membranes stretching the cervix. Near term, the fetus and placenta release hormones like cortisol and CRH that help trigger labour by stimulating prostaglandin production.
This presentation contains :-
1.Introduction of normal labour
2. Definiation of normal labour
3.Criteria of normal labour
4. Physiology of normal labour
5. Pathophysiology of labor
6.Estrogen
7. Prostaglandin
8. Oxytocin
9. True labor and false labor difference
10. Uterine contraction in labor
11. Stages of labour
12. Management of 1 st stage
13. management of 2 nd stage
14. mamagement of 3 rd stage of labor
15. Cervix dilation
16. Friedman's curve
17. Fetal skull
18. Diameter of fetal skull
19. Sutures in fetal head
20. Moulding
21. Mechanism of labour
Preterm labor is the labor that starts before the 37th completed week. In this presentation, we will discover causes, pathogenesis, diagnosis, clinical features, and management principles for preterm labor along with the most recent evidence.
CTG in simple methods in fetal assessment according to RCOG guidelines.
easy and concise
feel free to download
by OSAMA AKL
MRCOG instructor
contact me on WhatsApp 00201008067383
Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children.
This presentation contains :-
1.Introduction of normal labour
2. Definiation of normal labour
3.Criteria of normal labour
4. Physiology of normal labour
5. Pathophysiology of labor
6.Estrogen
7. Prostaglandin
8. Oxytocin
9. True labor and false labor difference
10. Uterine contraction in labor
11. Stages of labour
12. Management of 1 st stage
13. management of 2 nd stage
14. mamagement of 3 rd stage of labor
15. Cervix dilation
16. Friedman's curve
17. Fetal skull
18. Diameter of fetal skull
19. Sutures in fetal head
20. Moulding
21. Mechanism of labour
Preterm labor is the labor that starts before the 37th completed week. In this presentation, we will discover causes, pathogenesis, diagnosis, clinical features, and management principles for preterm labor along with the most recent evidence.
CTG in simple methods in fetal assessment according to RCOG guidelines.
easy and concise
feel free to download
by OSAMA AKL
MRCOG instructor
contact me on WhatsApp 00201008067383
Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children.
NORMAL LABOR.. (EUTOCIA) ABNORMAL LABOR ALSO EXPLAINED. Series of events that take place in the genital organs in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called LABOR.
This topic contains detailed description about labour, its definition, date of onset of labour, calculations of date of delivery, causes of onset of labour, physiology of normal labour, and events, clinical course and management of each stages of labour.
The onset of parturition, commonly known as labor, is a complex physiological process that marks the culmination of pregnancy and the initiation of the birthing process. This intricate sequence of events involves a series of hormonal, mechanical, and neurological changes that ultimately lead to the expulsion of the fetus from the mother's uterus. Understanding the onset of parturition requires a comprehensive exploration of the various stages and factors involved.
The process of parturition can be broadly categorized into three main stages: pre-labor, labor, and post-labor. The pre-labor stage encompasses the preparatory changes occurring in the days and weeks leading up to labor, while the labor stage involves the actual contractions and cervical dilation facilitating delivery. The post-labor stage involves the expulsion of the placenta and the initial postpartum adjustments.
The hormonal regulation of parturition is a crucial aspect of its onset. Throughout pregnancy, the placenta produces progesterone, a hormone that maintains the uterine environment and prevents premature contractions. As term approaches, the ratio of progesterone to estrogen changes, leading to a decline in progesterone levels and a subsequent increase in estrogen. This shift triggers a cascade of events, including the activation of uterine contractions and the initiation of cervical ripening.
The role of oxytocin, often referred to as the "love hormone" or "cuddle hormone," is paramount in the onset of labor. Produced by the hypothalamus and released by the pituitary gland, oxytocin stimulates uterine contractions. Additionally, oxytocin plays a crucial role in the positive feedback loop of labor – as contractions intensify, more oxytocin is released, further promoting labor progression.
Mechanical factors also contribute to the onset of parturition. The growing fetus applies pressure on the cervix and uterine walls, leading to the release of prostaglandins. Prostaglandins are lipid compounds that promote uterine contractions and cervical ripening. The combination of hormonal changes and mechanical pressure creates a synergistic effect, fostering the progression of labor.
The intricate interplay between the maternal-fetal unit and the surrounding environment further influences the onset of parturition. Maternal stress, for instance, can impact the release of corticotropin-releasing hormone (CRH), which, in turn, influences the production of other hormones involved in labor. Moreover, the fetus itself plays an active role in signaling its readiness for delivery through various molecular signals.
The onset of labor is often heralded by a set of common signs. These may include the engagement of the fetal head into the pelvis, the "bloody show" – a discharge of mucus mixed with blood resulting from cervical changes, and the rupture of the amniotic sac, leading to the release of amniotic fluid. These signs, in conjunction with regular and increasingly intense contractions.
Series of events that takes place in the genital organ in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour.
there are four stages of labour.
In-depth explanation of labor divided into two extensive parts. A thorough examination of proper procedure, care, and health for expecting mothers. Delicate consideration must be taken to insure the safety of the baby and promote the best chances for a healthy delivery. Topics such as biochemical messengers, hormonal balance, preterm conditions, fetal position, and cardinal movements.
physiological changes during pregnancy
effect of pregnancy on physiological functions during pregnancy
cardiovascular, respiratory and hormonal changes
Shifa Riaz
gynecology
obstetrics
females
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Causesandonsetoflabour 130108101535-phpapp02
1. CAUSES AND ONSET OF LABOUR
PRESENTED BY :
DR PAWAN JHALTA
MODERATOR :
DR GEETIKA
2. LABOUR
Labour – is a physiologic process during which the
products of conception (i.e., the fetus, membranes,
umbilical cord and placenta) are expelled outside
the uterus
3. The following criteria should be
present to call it normal labour:
Spontaneous onset
Spontaneous expulsion,
of a single,
mature foetus,
presented by vertex,
through the birth canal,
within a reasonable time (not less than 3
hours or more than 18 hours),
without complications to the mother, or the
foetus.
4. Onset of labour
I. Characterized by
The show
True labour pains
Dilatation and effacement of cervix
Formation of bag of forewaters
5. 5/34
Show (bloody show)
- sign of the impending onset of active labor
- extrusion of mucus plug of the cervical canal
Discharge of small amount of blood-tinged
mucus from vagina
The show
6. True labour pains
Uterine Contractions Characteristic of Labor
; muscular contractions, those of uterine smooth
muscle of labor are painful
cause of pain (not known definitely)
① hypoxia of contracted myometrium
② compression of nerve ganglia in cervix & lower
uterus by the tightly interlocking muscle bundles
③ stretching of cervix during dilatation
④ stretching of peritoneum overlying the fundus
7. Interval between contractions
: 10 minutes at the onset of the first stage
→ diminishes gradually
→ 1 minute or less in the second stage
Periods of relaxation between contractions
- essential to welfare of the fetus
- unremitting contraction of uterus compromises
uteroplacental blood flow, cause fetal hypoxia
Duration of contraction in active phase
Duration 30-90 seconds (average 60 sec)
Pressure 20-60 mmHg (average 40 mmHg
8. Dilatation and effacement of cervix
•
• • Effective force of the 1st stage of labor is uterine
• contraction
• • As the result of the action of these forces, two
• fundamental changes take place in the already
• ripened cervix
• “effacement & dilatation”
• • The cervix is said to be completely (fully)
• dilated : 10 cm
9. Cervical Effacement
obliteration or taking up of the cervix
shortening of the cervical canal (2cm → mere
circular orifice with almost paper thin edge)
muscular fibers at about the level of the
internal os are pulled upward or “taken up”
into the lower uterine segment
10. Formation of bag of forewaters
The process of cervical effacement
and dilatation causes the formation
of the forebag of amniotic fluid
which is the leading portion of
amniotic sac and fluid located in
front of the presenting part
11.
12. Phase 1 Phase 2 Phase 3 Phase 4
Quiescence Activation Stimulation Involution
Prelude to Preparation Processes Parturient
parturition for labor of labor recovery
Contractile Uterine Uterine Uterine
Unresponsiveness, preparedness contraction, involution
cervical softening for labor, cervical dilation, cervical repair,
cervical fetal and placenta breast feeding
ripening expulsion (three
stages of labor)
Conception Initiation of onset of
parturition labor Delivery of
conceptus Fertility
restored
THE PHASES OF PARTURITION
13. Phase I :uterine quiescence and
cervical softening
In this phase the inherent propensity of
myometrium to contract is held in abeyance and
uterine muscle is rendered unresponsive to
natural stimuli.
Although some myometrial contraction of low
intensity and brief duration that do not cause
cervical dilatation are noted during this phase.
Near the end of pregnancy ,contractions of this
type become more common, especielly in
multiparous women reffered to as Braxton Hicks
contractions or false labour
14. Cervical softening
Cervical softening is characterzed by an
increase in tissue compliance,yet the cervix
remains firm and unyielding.
Cervical softening results from increased
vascularity,glandular hypertrophy and
hyperplasia,and compositional or structural
changes of the extracellular matrix.
15. Phase I : biochemical and
physiological changes
Progesterone and oestrogen:
administration of progesterone
receptor antagonist will promote
some or all key features of onset of
labour like cervical ripening
,increased cervical distensibility and
increased uterine sensitivity to
uterotonins.
16. Steroid hormone regulation of
myometrial cell to cell
communication ; progeterone causes
decreased expression of contraction
associated proteins and is also
known to inhibit expression of gap
junctional proteins and thus
increases uterine quiescence.
17. G-protein coupled receptors that
promote myometrial relaxation
Beta –Adrenoreceptors:β –adrenergic receptors mediates
Gαs-stimulated increases in adenylyl cyclase,increased levels of
cAMP and myometrial cell relaxation
LH and hCG receptors :these receptors during pregnancy
are greater before than during labour and activates
adenylyl cyclase by way of plasma membrane receptor Gαs-
linked system.
Relaxin ;relaxin family peptide receptor-1-mediates
activation of adenylyl cyclase and thus may promote
uterine relaxation
18. CRH ;synthesized in placenta and
hypothalamus ,found to have dual role during
pregnancy and labour,
During pregnancy it binds the receptor CRH-
R1 production of cAMP and
subsequent inhibition of myometrial activity
At term CRH can activate the Gqα protein
pathway which favours myometrial
contraction
19. Prostaglandins ;most commonly considered as
uterotonins however they have diverse effects
and some acts as smooth muscle relaxants
Both PGE2 and PGI2 could potentially act to
maintain uterine quiscence by increasing
cAMP signaling yet PGE2 can promote uterine
contractility through binding to EP1 and EP2
receptors
20. Thus either the generation of specific
prostaglandins or relative expression of the
various prostaglandins receptors may
determine myometrial response to
prostaglandins
Atrial and brain natriuretic peptide and
cGMP:cGMP levels can be stimulated by either
ANP and BNP and promotes smooth muscle
relaxation .BNP is secreted by amnion in large
amounts and ANP is expressed in placenta
21. Accelerated uterotonin degradation
In addition to pregnancy induced compounds
that stimulates myometrial cell refractoriness
there are striking increases in enzymes that
degrade or inactivates endogenously produced
uterotonins which includes:
PGDH and prostaglandins
Oxytocinase and oxytocin
Diamine oxidase and histamine
Angiotensinases and angiotensin II
PAF acetylhydrolase and PAF
22.
23. Phase II :uterine activation and
cervical ripening
Myometrial changes include marked increase in
oxytocin receptors ,prostglandin receptors and increase
in number and surface area of gap junction proteins
such as connexin43 .together these leads to increased
uterine irritability and responsiveness to uterotonins.
Another critical change in phase 2 is formation of lower
uterine segment from the isthmus .with this
development lightening occurs .it is also likely that
lower segment myometrium is unique from that of
upper segment resulting in distinct role for each in
labour.there are studies that reports an expression
gradient of oxytocin receptors with higher expression
in fundal myometrium.
24. Cervical ripening in phase2
The transition from softening to ripening
begins weeks or days before onset of
contractions.
The cervix is made up of only 10 to 15 percent
smooth muscle and remaining is connective
tissue which includes type 1,3 and 4
collagen,glycosaminoglycans, proteoglycans
and elastin
25. During cervical ripening collagen fibrils are
disorganized and there is increased spacing
between fibrils and the total amount and
composition of proteoglycans and
glycosaminoglycans within the matrix are
altered
26. Phase II: physiological and
biochemical processes
Progesterone functional withdrawl:this can be
mediated through several mechanisms
Changes in the relative expression of of
nuclear progesterone receptor isoforms,PR-
A,PR-B and PR-c
Changes in relative expression of membrane
bound progesterone receptors
27. Posttranslational modifications of
progesterone receptor
Alterations in progesterone receptor activity
through changes in in the expression of co-
activators or co-repressors that directly
influence receptor function
Local inactivation of progesterone by steroid-
metabolizing enzymes or synthesis of a natural
antagonist.
28. Oxytocin receptors
There is an increase in myometrial
oxytocin receptors and there
activation results in increased
phospholipase C activity and
subsequent increase in cytosolic
calcium and uterine contractility
29. Relaxin
Causes remodeling of extracellular
matrix of uterus,cervix,vagina, breast
and pubic symphysis as well as
promoting cell proliferation and
inhibiting apoptosis.
30. Fetal contribution to initiation of
labour
Uterine stretch and parturition is
required for induction of contraction
associated proteins.
Stretch increases expression of gap
junction protein-connexin 43,as well
as oxytocin receptors.
31. Fetal endocrine cascade
At term the fetal adrenal glands weigh same as
those in the adults and similar in size
The daily production of steroid by adrenal glands
near term is 100 to 200mg/day higher than 30 to
40mg/day seen in adult glands at rest
Fetal cortisol levels increase during the last weeks
of gestation during the same period levels of
DHEA-S also increases significantly leading to
increase in maternal oestrogens particularly
estriol.
32.
33. Placental CRH production
A CRH hormone identical to maternal and
fetal hypothalamic CRH is synthesized by
placenta in relatively large amounts.
One important difference is that,unlike
hypothalamic CRH which is under
glucocorticoid negative feedback , cortisol has
been shown to stimulate placental CRH
production.
34. This ability makes it possible to create a feed
forward endocrine cascade that does not end
untill separation of fetus from placenta at
delivery.
Resulting high levels of CRH may modulate
myometrial cotractility via interaction with the
CRH receptor isoform CRH-R1d this isoform is
known to enhance myometrial contractile
response
35. It has also been proposed that cortisol affects
the myometrium indirectly by stimulating the
fetal membranes to increase PG synthesis
Finally CRH has been shown to stimulate fetal
adrenal C19- steroid synthesis thereby
increasing substrate for placental
aromatization and increased levels of
oestrogen
36. Fetal lung surfactant
Pulmonary surfactant and its
components such as PAF when
secreted into amniotic fluid have
been reported to stimulate PG
synthesis and uterine contractility
37. CAUSES OF ONSET OF LABOUR
Mechanical Biochemical
Uterine distension Oxytocin
theory Prostaglandins
PAF
Stretch of the lower Angiotensin II
Uterine segment by Histamine
presenting pact Serotonin & Others
Mechanical stretching of cervix
(Ferguson’s Reflex) & stripping
of fetal membranes
38. Uterine distension theory
This theory is supported by the observation
that multifetal pregnancy and pregnancies
associated with polyhydramnios are atmuch
greater risk for lreterm labour than singletons.
39. Fergusons reflex
mechanical stretching of cervix enhances
uterine activity ,release of oxytocin has been
suggested but not proven.
: manipulation of the cervix and stripping the
fetal membranes is associated with an
increase in PGF2αmetabolite in blood.
: exact mechanism : not clear
40. Biochemical and Physiological
processes
Current data favour uterotonins theory of
labour initiation
Increased number of uterotonin production
would follow once phase 1 is suspended and
uterine phase 2 processes are implemented
41. Oxytocin
It was first uterotonin to be implicated in
parturition initiation following observations
provide support for this theory
The number of oxytocin receptors strikingly
increases in myometrial and decidual tissues near
end of gestation
Oxytocin acts on decidual tissue to promote
prostaglandin release
Oxytocin is synthesized directly in decidual and
extraembryonic fetal tissues and in the placenta.
42. Platelet activating factor
The PAF receptor is a member of the G-
protein- coupled receptor family of
transmembrane receptors.
Its stimulation by PAF increases myometrial
cell calcium levels and promotes uterine
contractions.
Levels of PAF in amnionic fluid are increased
during labor PAF treatment of myometrial
tissue promotes contraction.
43. Prostaglandins
Evidence supportive of this theory includes;
Levels of prostaglandins or their metabolites in
amniotic fluid ,maternal plasma and maternal
urine are increased during labour
Treatment of pregnant women with PGs by any of
several routes of administration,causes abortion
or labour at all stages of gestation.
Administration of PGHS type 2 inhibitors to
pregnant women will delay spontaneous onset of
labour and sometimes arrest preterm labour.
44. Endothelin-1
The endothelins are a family of 21-amino acid
peptides that powerfully induce myometrial
contraction.
It is produced in myometrium and its potential
contribution to phase 3 of parturition is not
defined.
45. Angiotensin-II
There are two G-protein-linked angioteneism
II receptors in the uterus - AT1 and AT2.
In non pregnant women the AT2 receptors is
predominant, but the AT1 receptor is
preferentially expressed in pregnant.
Angiotenism II is binding to the plasm-
membrane receptor evokes contraction.
46. Crticotropin-Releasing Hormone(CRH)
Late in pregnancy – phase 2 or 3 of parturition –
modification in the CRH receptor favours a switch
cAMP formation to increased myometrial cell calcium
levels via protein kinase C activation.
Oxytocin acts attentuate CRH-stimulated accumulation
of cAMP myometrial tissue and CRH augments the
contraction-inducing potency of a given dose of
oxytocin n human myometrial strips.
Finally CRH acts to increase myometrial contractile
force in response to PGF2α.