Myometrial function in prematurity

Andrew M. Blanks, Anatoly Shmygol, Steven Thornton

Research output: Contribution to journalReview articlepeer-review

18 Citations (Scopus)

Abstract

The primary function of the uterus during gestation is to harbour the growing conceptus in a largely quiescent environment. Upon maturation of the fetus to a point sufficient for extrauterine survival, the uterus must remodel itself sufficiently to generate forceful contractions during labour. During preterm delivery, the process of remodelling of the myometrium occurs early due to a number of different causes, although the underlying basis for myometrial contraction remains the same. This review summarises the anatomical, physiological and molecular basis for contraction. We describe the fibre structure of the human uterus and how this relates to the spread of electrical excitation during a contraction. The process of excitation within a single myometrial cell is described, as well as how this relates to contraction. We then focus on how excitation-contraction coupling is modulated by intercellular communication, pharmacomechanical-coupling and hormonal milieu. Lastly, we consider the actions of the commonly accepted uterine agonists oxytocin, prostaglandin F, and prostaglandin E2, and the tocolytic ritodrine.

Original languageEnglish
Pages (from-to)807-819
Number of pages13
JournalBest Practice and Research in Clinical Obstetrics and Gynaecology
Volume21
Issue number5
DOIs
Publication statusPublished - Oct 2007
Externally publishedYes

Keywords

  • excitation-contraction coupling
  • myometrium
  • oxytocin
  • pharmacomechanical coupling
  • prostaglandins
  • ritodrine
  • uterus

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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