RESUMO
Labouring women have been shown to have slower gastric emptying than non-pregnant subjects, and this argument is sometimes used to recommend fasting guidelines such as nil-by-mouth during labour. We performed a parallel group, randomised non-inferiority trial, comparing gastric emptying of 450 ml isocalorically-adjusted maltodextrin, coffee with milk or pulp-free orange juice, with 18 women in each group. The women were initially fasted for 2 h for clear fluids, 6 h for a light meal and 8 h for a high fat or high protein meal. We performed gastric ultrasound in the semirecumbent-right lateral decubitus position. Gastric antral area was measured at baseline and at 5 min, 30 min, 60 min, 90 min and 120 min. Gastric emptying of maltodextrin was significantly faster than coffee with milk (p < 0.001) and orange juice (p < 0.001). There was no statistically significant difference between pulp-free orange juice and coffee with milk (p = 0.97). The estimated gastric residual volume was lower than baseline from 90 min after drinking maltodextrin. In labouring women, maltodextrin is cleared from the stomach faster than coffee with milk and orange juice. Gastric emptying depends on other factors besides the caloric load and volume of the drink.
Assuntos
Citrus sinensis/metabolismo , Café/metabolismo , Sucos de Frutas e Vegetais , Esvaziamento Gástrico/fisiologia , Trabalho de Parto/metabolismo , Leite/metabolismo , Polissacarídeos/metabolismo , Adulto , Animais , Feminino , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Gravidez , Estômago/diagnóstico por imagem , Estômago/fisiologia , UltrassonografiaRESUMO
Proper myometrial adaptation during gestation is crucial for embryo implantation, pregnancy maintenance and parturition. Previously, we reported that neonatal exposure to endosulfan alters uterine development and induces implantation failures. The present work investigates the effects of endosulfan exposure on myometrial differentiation at the pre-implantation period, and myometrial activation during labor. Newborn female rats were s.c. injected with corn oil (vehicle) or 600⯵g/kg/day of endosulfan (Endo600) on postnatal days (PND) 1, 3, 5 and 7. On PND90, the rats were mated to evaluate: i) the myometrial differentiation on gestational day 5 (GD5, pre-implantation period), by assessment myometrial histomorphology, smooth muscle cells (SMCs) proliferation, and expression of proteins involved in myometrial adaptation for embryo implantation (steroid receptors, Wnt7a and Hoxa10); ii) the timing of parturition and myometrial activation during labor by determining the uterine expression of contraction-associated genes (oxytocin receptor, OTXR; prostaglandin F2α receptor, PTGFR and connexin-43, Cx-43). Endosulfan decreased the thickness of both myometrial layers, with a concomitant decrease in the collagen remodeling. Blood vessels relative area in the interstitial connective tissue between muscle layers was also decreased. Endo600 group showed lower myometrial proliferation in association with a downregulation of Wnt7a and Hoxa10. Although in all females labor occurred on GD23, the exposure to endosulfan altered the timing of parturition, by inducing advancement in the initiation of labor. This alteration was associated with an increased uterine expression of OTXR, PTGFR and Cx-43. In conclusion, neonatal exposure to endosulfan produced long-term effects affecting myometrial adaptation during early pregnancy and labor. These alterations could be associated with the aberrant effects of endosulfan on the implantation process and the timing of parturition.
Assuntos
Adaptação Fisiológica/efeitos dos fármacos , Endossulfano/administração & dosagem , Inseticidas/administração & dosagem , Trabalho de Parto/efeitos dos fármacos , Miométrio/efeitos dos fármacos , Contração Uterina/efeitos dos fármacos , Útero/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Diferenciação Celular , Feminino , Trabalho de Parto/metabolismo , Miométrio/crescimento & desenvolvimento , Miométrio/metabolismo , Gravidez , Ratos , Ratos Wistar , Contração Uterina/metabolismo , Útero/crescimento & desenvolvimento , Útero/metabolismoRESUMO
Prior to and during the process of human labor, maternal circulating leukocytes infiltrate the maternal-fetal interface (choriodecidua) and become activated resembling choriodecidual leukocytes. Since, there is no evidence comparing maternal circulating and choriodecidual leukocytes, herein, we characterized their transcriptome and explored the biological processes enriched in choriodecidual leukocytes. From women undergoing spontaneous term labor we isolated circulating and choriodecidual leukocytes, performed microarray analysis (n = 5) and qRT-PCR validation (n = 9) and interaction network analysis with up-regulated genes. We found 270 genes up-regulated and only 17 genes down-regulated in choriodecidual leukocytes compared to maternal circulating leukocytes. The most up-regulated genes were CCL18, GPNMB, SEPP1, FN1, RNASE1, SPP1, C1QC, and PLTP. The biological processes enriched in choriodecidual leukocytes were cell migration and regulation of immune response, chemotaxis, and humoral immune responses. Our results show striking differences between the transcriptome of choriodecidual and maternal circulating leukocytes. Choriodecidual leukocytes are enriched in immune mediators implicated in the spontaneous process of labor at term.
Assuntos
Decídua/metabolismo , Trabalho de Parto/genética , Leucócitos/metabolismo , Transcriptoma , Adulto , Decídua/citologia , Feminino , Humanos , Trabalho de Parto/sangue , Trabalho de Parto/metabolismo , GravidezRESUMO
BACKGROUND: The activity of matrix degrading enzymes plays a leading role in the rupture of the fetal membranes under normal and pathological human labor, and matrix metalloproteinase-9 (MMP-9) it is considered a biomarker of this event. To gain further insight into local MMP-9 origin and activation, in this study we analyzed the contribution of human placental leukocytes to MMP-9 secretion and explored the local mechanisms of the pro-enzyme activation. METHODS: Placental blood leukocytes were obtained from women at term gestation without labor and maintained in culture up to 72 h. MMP-9 activity in the culture supernatants was determined by zymography and using a specific substrate. The presence of a potential pro-MMP-9 activator in the culture supernatants was monitored using a recombinant biotin-labeled human pro-MMP-9. To characterize the endogenous pro-MMP-9 activator, MMP-1, -3, -7 and -9 were measured by multiplex assay in the supernatants, and an inhibition assay of MMP-9 activation was performed using an anti-human MMP-3 and a specific MMP-3 inhibitor. Finally, production of MMP-9 and MMP-3 in placental leukocytes obtained from term pregnancies with and without labor was assessed by immunofluorescence. RESULTS: Placental leukocytes spontaneously secreted pro-MMP-9 after 24 h of culture, increasing significantly at 48 h (P≤0.05), when the active form of MMP-9 was detected. Culture supernatants activated the recombinant pro-MMP-9 showing that placental leukocytes secrete the activator. A significant increase in MMP-3 secretion by placental leukocytes was observed since 48 h in culture (P≤0.05) and up to 72 h (P≤0.001), when concentration reached its maximum value. Specific activity of MMP-9 decreased significantly (P≤0.005) when an anti-MMP-3 antibody or a specific MMP-3 inhibitor were added to the culture media. Placental leukocytes from term labor produced more MMP-9 and MMP-3 compared to term non-labor cells. CONCLUSIONS: In this work we confirm that placental leukocytes from human term pregnancies are able to secrete large amounts of MMP-9, and that the production of the enzyme it is enhanced by labor. We also demonstrate for the first time that endogenous MMP-3 plays a major role in MMP-9 activation process. These findings support the contribution of placental leukocytes to create the collagenolytic microenvironment that induces the rupture of the fetal membranes during human labor.
Assuntos
Trabalho de Parto/sangue , Trabalho de Parto/metabolismo , Leucócitos/metabolismo , Metaloproteinase 3 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Placenta/citologia , Sobrevivência Celular , Colágeno/metabolismo , Ativação Enzimática , Precursores Enzimáticos/metabolismo , Feminino , Humanos , Leucócitos/citologia , Leucócitos/enzimologia , GravidezRESUMO
OBJECTIVE: To test the effect of prolactin (PRL) on expression of proinflammatory cytokines and matrix metallopeptidase 9 (MMP-9) in vitro. STUDY DESIGN: Tissue explants were incubated from 4 to 48 hours alone or in the presence of 500 ng/mL PRL, and mRNA expression in tissues and secretion of interleukin (IL)-1ß, tumor necrosis factor alpha (TNF-α), MMP-2, and MMP-9 was quantified. RESULTS: Fetal membranes secreted IL-1ß, TNF-α, and MMP-9 in culture with consistent low concentration during the first 24 hours and then increased progressively. The presence of PRL during explant incubation significantly decreased the patterns of IL-1ß, TNF-α and MMP-9 secretion along culture (P < .001). MMP-2 secretion was unaffected by PRL. The relative basal expression of IL-1ß mRNA (1.2 ± 0.87) was reduced by 80% in the presence of PRL after 32 hours of incubation of the membranes (P = .001). The expression of the TNF-α mRNA was not modified by the presence of PRL (0.06 ± 0.01) compared with the basal expression levels (0.05 ± 0.01). MMP-9 mRNA basal expression (0.018 ± 0.008) was significantly reduced (P = .001) in the presence of PRL after 32 hours (0.002 ± 0.0005). CONCLUSION: PRL may be a potential candidate as a key signal controlling the expression of signals related to the proinflammatory reaction associated with human labor.
Assuntos
Membranas Extraembrionárias/metabolismo , Interleucina-1beta/metabolismo , Trabalho de Parto/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Prolactina/metabolismo , Nascimento a Termo/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Técnicas In Vitro , Gravidez , Reação em Cadeia da Polimerase em Tempo RealRESUMO
OBJECTIVE: To assess the concentration of progesterone (PRs) and oestrogen (ORs) receptors of myometrium of full-term pregnant women in the myometrium of lower segment of the uterus in relationship with presence or absence of labour. METHODS: This was a cross-sectional prospective study with 21 pregnant women, being 6 in labour (Group I) and 15 without labour (Group II). The biopsy of myometrium was realized during caesarian section, and the excised tissue was stained using immunohistochemical techniques for the quantification of the receptors, and with the aid of image-analysis software, the numbers of receptors for each hormone were determined spectrophotometrically. The Mann-Whitney test was used to compare the pregnant women in each study group with respect to the numbers of ORs and PRs. The Wilcoxon test was used to compare the concentration of ORs and PRs in each group separately. RESULTS: The mean of gestational age was 39 weeks, (range, 37 to 41 weeks). The medians of PRs and ORs in pregnant women in labour (Group I) were 29.3 (range, 24.6-30.2) and 32.3 (range, 22.9-49.0), respectively. The medians of PRs and ORs in pregnant women without labour (Group II) were 43.6 (range, 23.6-70) and 43.9 (range, 18.3-62.6), respectively. We did not observe significant differences of the number of ORs and PRs in both groups (P = 0.13 and 0.37, resp.). The number of ORs was statistically more than that of PRs in Group II (Z calculated = 16.00). CONCLUSION: The concentrations of PRs and ORs were similar in the myometrium of the lower uterine segment of pregnant women during and without labour, but the concentration of ORs was more than that of PRs in the myometrium of the lower uterine segment of pregnant women without labour.
Assuntos
Trabalho de Parto/metabolismo , Miométrio/química , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Estudos Transversais , Feminino , Humanos , Gravidez , Terceiro Trimestre da Gravidez , Estudos ProspectivosRESUMO
We postulate that protein kinase C α (PKCα) may contribute to the maintenance of pregnancy myometrial quiescence in humans. We studied the changes in myometrial PKCα gene products (messenger RNA [mRNA] and protein) in 4 groups of women: preterm not in labor (PT-NL), preterm in labor (PT-L), term not in labor (T-NL), and term in labor (T-L). The degree of PKCα activation was studied by comparing the levels of particulate (active) PKCα with the total PKCα protein levels and by measuring PKCα activity in the cytosolic and particulate fractions. Protein kinase Cα abundance (mRNA and protein) did not increase during myometrial quiescence (PT-NL), whereas the level of PKCα activity significantly increased during quiescence. The activity of PKCα significantly decreased in the T-NL, T-L, and PT-L groups. These findings suggest that PKCα plays a significant role in the maintenance of myometrial quiescence and that PKCα activity must decrease at the end of pregnancy allowing myometrial activation. Additionally, our data demonstrate an association between reduced PKCα activity and preterm labor, which merits further investigation.
Assuntos
Trabalho de Parto/metabolismo , Miométrio/enzimologia , Trabalho de Parto Prematuro/enzimologia , Proteína Quinase C-alfa/biossíntese , Biomarcadores/metabolismo , Ativação Enzimática/fisiologia , Feminino , Humanos , Isoenzimas/biossíntese , Isoenzimas/genética , Trabalho de Parto/genética , Trabalho de Parto Prematuro/genética , Gravidez , Proteína Quinase C-alfa/genética , RNA Mensageiro/biossíntese , RNA Mensageiro/genéticaRESUMO
Remodeling and relaxation of the mouse pubic symphysis (PS) are central events in parturition. The mouse PS remodels in a hormone-controlled process that involves the modification of the fibrocartilage into an interpubic ligament (IpL), followed by its relaxation prior to parturition. It is recognized that nitric oxide synthase (NOS) and consequently nitric oxide (NO) generation play important roles in extracellular matrix modification, and may promote cytoskeleton changes that contribute to the remodeling of connective tissue, which precedes the onset of labor. To our knowledge, no studies thus far have investigated inducible nitric oxide synthase (iNOS) expression, protein localization, and NO generation in the mouse PS during pregnancy. In this work, we used a combination of the immunolocalization of iNOS, its relative mRNA expression, and NO production to examine the possible involvement of iNOS in remodeling and relaxation of the mouse IpL during late pregnancy. The presence of iNOS was observed in chondrocytes and fibroblast-like cells in the interpubic tissues. In addition, iNOS mRNA and NO production were higher during preterm labor on Day 19 of pregnancy (D19) than NO production on D18 or in virgin groups. The significant increase in iNOS mRNA expression and NO generation from the partially relaxed IpL at D18 to the completely relaxed IpL at D19 may indicate that NO plays an important role in late pregnancy during relaxation of the mouse IpL.
Assuntos
Trabalho de Parto/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico/metabolismo , Prenhez/metabolismo , Sínfise Pubiana/metabolismo , RNA Mensageiro/metabolismo , Análise de Variância , Animais , Condrócitos/metabolismo , Feminino , Fibroblastos/metabolismo , Imuno-Histoquímica , Ligamentos/química , Ligamentos/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Óxido Nítrico Sintase Tipo II/genética , Gravidez , Prenhez/genética , RNA Mensageiro/análise , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo RealRESUMO
BACKGROUND: Pregnancy is accompanied by several hemodynamic, biochemical and hematological changes which revert to normal values after labor. The mean values of these parameters have been reported for developed countries, but not for Mexican women. Furthermore, labor constitutes a stress situation, in which these factors may be altered. It is known that serologic increase of heat shock protein (Hsp) 70 is associated with abnormal pregnancies, presenting very low level in normal pregnant women. Nevertheless, there are no studies where these measurements are compared in healthy pregnant women at their third trimester of pregnancy (3TP) and the active labor phase (ActLP). METHODS: Seventy five healthy Mexican pregnant women were included. Hemodynamic, biochemical and hematological parameters were obtained in all cases, and serum Hsp70 levels were measured in a sample of 15 women at 3TP and at ActLP. RESULTS: Significant differences were found in most analysis performed and in Hsp70 concentration at 3TP as compared to ActLP, however all were within normal range in both conditions, supporting that only in pathological pregnancies Hsp70 is drastically increased. CONCLUSION: Results obtained indicate that 3TP and ActLP have clinical similarities in normal pregnancies, therefore if abnormalities are found during 3TP, precautions should be taken before ActLP.
Assuntos
Trabalho de Parto/fisiologia , Terceiro Trimestre da Gravidez/fisiologia , Gravidez/metabolismo , Gravidez/fisiologia , Adolescente , Adulto , Contagem de Células Sanguíneas , Glicemia/metabolismo , Pressão Sanguínea/fisiologia , Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Feminino , Proteínas de Choque Térmico HSP70/metabolismo , Frequência Cardíaca/fisiologia , Frequência Cardíaca Fetal/fisiologia , Hematócrito , Hemoglobinas/metabolismo , Humanos , Trabalho de Parto/metabolismo , México , Terceiro Trimestre da Gravidez/metabolismo , Taxa Respiratória/fisiologia , Adulto JovemRESUMO
Several studies indicate that at the choriodecidual interface, where maternal and fetal tissues make contact, a network of signals is established during labor that includes infiltration of leukocytes and secretion of pro-inflammatory cytokines. In this review, we provide an overview of the inflammatory milieu present in the choriodecidua during membrane rupture, describe the recruitment and homing of leukocytes to the reproductive tissues, and detail specific actions of the key chemokines released by the choriodecidual cells. These data lend further support to the hypothesis that labor is an inflammatory response, wherein the infiltrated leukocytes in the choriodecidua interface could be contributing to the creation of a microenvironment leading to collagenolysis, which would promote the rupture of these tissues during labor. In addition to the available information describing biological actions of chemokines during various pathological conditions such as infection, preterm labor and preterm rupture of membranes suggest that these compounds play important roles in other gestational events such as cervical dilation and myometrial contractions. Even though we do not know the totality of biochemical signals that integrate the molecular dialogue between leukocytes and the various gestational tissues, it is becoming increasingly evident that this microenvironment is characterized, at least in part, by the differential expression and secretion of chemokines that induce selective trafficking of leukocyte subsets to the fetal membranes. Therefore, chemokines should be considered as important regulatory molecules with the ability to initiate the events that characterize normal and pathological labor.
Assuntos
Quimiocinas/metabolismo , Membranas Extraembrionárias/metabolismo , Ruptura Prematura de Membranas Fetais/metabolismo , Trabalho de Parto/metabolismo , Quimiotaxia/fisiologia , Colágeno/metabolismo , Feminino , Humanos , Subpopulações de Linfócitos/fisiologia , GravidezRESUMO
BACKGROUND: The human labor is an inflammatory process invading leukocytes modulated by gestational tissues. The local increase of cell adhesion molecules (CAMs) promotes the permanence of these leukocytes in the coriodecidua. Gestational tissues express ICAM-1, while circulating leukocytes expressing its ligand Mac-1. OBJECTIVE: To analyze, first, if the expression of CAMs in the fetal membranes is associated with progress of gestational age, and second, the expression of CAMs on circulating leukocytes in the uterus (placenta). MATERIAL AND METHOD: original and closed study conducted at the Instituto Nacional de Perinatologia Isidro Espinosa de los Reyes (Mexico City). We included samples from healthy women between 15 and 44 years of age with term pregnancies (> or =37 weeks gestation). RESULTS: Real time PCR analysis showed that the expression of CAMs in the fetal membranes remained constant before labor. ICAM3 and ICAM1 tended to increase during labor, while ICAM2, VCAM1, SELE and SELP decrease with advancing gestational age. Placental leukocytes showed a clear increase in the expression of ITGAM (Mac-1) during labor. CONCLUSIONS: These results show that the maternal-fetal interface expresses a specific combination of CAMs during labor, including ICAM1, ICAM-3 and Mac-1. The expression of these molecules could promote the retention of leukocytes in the local tissues to modulate the local inflammatory microenvironment during human labor.
Assuntos
Moléculas de Adesão Celular/metabolismo , Membranas Extraembrionárias/metabolismo , Trabalho de Parto/metabolismo , Leucócitos/metabolismo , Terceiro Trimestre da Gravidez/metabolismo , Adolescente , Adulto , Distinções e Prêmios , Células Sanguíneas/metabolismo , Quimiotaxia de Leucócito , Sistemas Computacionais , Feminino , Idade Gestacional , Ginecologia , Humanos , Inflamação , México , Obstetrícia , Placenta/citologia , Placenta/metabolismo , Reação em Cadeia da Polimerase , Gravidez , Adulto JovemRESUMO
Objetivos: Conhecer o índice de complicações maternas e fetais imediatas nas cesáreas eletivas realizadas nos Hospital São João Batista de Criciúma no período de janeiro a junho de 2008. Métodos: Estudo do tipo coorte prospectivo, observacional,exploratório e documental com 107 pacientes que foram submetidas à cesárea eletiva, sendo excluídasaquelas que entraram em trabalho de parto antes da cirurgia. Resultados: Das 107 pacientes estudadas, duas nãopreencheram os critérios de inclusão, resultando em 105 pacientes na amostra. A idade média das pacientes foide 27,3 anos, com idade mínima de 18 anos e idade máxima de 41 anos. Com relação à idade gestacional, a média foi 38,5 semanas, variando de 36 a 41 semanas. Neste estudo, foram observadas duas complicações imediatas; sendo uma materna e uma fetal. Das 105 pacientes submetidas à cesárea, uma (0,95%) apresentouinfecção puerperal; enquanto nos recém nascidos, um (0,95%) apresentou taquipnéia transitória. Conclusão: Concluiu-se nesse trabalho, que apesardo índice de complicações imediatas maternas e fetais evidenciados nas cesáreas eletivas ter sido de 0,95%, acesárea eletiva não é um procedimento isento de risco.
Objectives: To know the rate of immediate maternal and fetal complications in the elective cesareans achieved in São João Hospital in Criciúma, from January to June of 2008.Methods: Cohort prospective study, observational, exploratory and documental with 107 patients who weresubmitted to elective cesarean, excluding those one who started the delivery labor until the surgery.Results: From the 107 patients studied, two didnt fill includes criterion, resulting in 105 patients in the sample.The median age of the patients was 27,3 years, with the minimal of 18 years and the maximum of 41 years. About the gestational age, the median was 38,5 weeks, changing between 36 and 41 weeks. In this study, was observed two immediate complications; one maternal and one fetal. From the 105 patients submitted to cesarean, one (0,95%) presents puerperal infection; while in theinfant, one (0,95%) presents transient tachypnea. Conclusion: Concluded in this study, that although the rate of immediate maternal and fetal complications evidenced in the elective cesarean was about 0,95%, the elective cesarean is not a procedure without risks.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Cesárea , Trabalho de Parto , Complicações na Gravidez , Infecção Puerperal , Cesárea/efeitos adversos , Cesárea/estatística & dados numéricos , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/fisiopatologia , Infecção Puerperal/diagnóstico , Infecção Puerperal/metabolismo , Infecção Puerperal/patologia , Trabalho de Parto/fisiologia , Trabalho de Parto/metabolismoRESUMO
We aim to demonstrate that Brain Natriuretic Peptide (BNP) is synthesized and released from the fetal membranes and mediates pregnancy myometrial quiescence. Myometrium and fetal membranes (FM) were obtained from term and preterm pregnancies at the time of cesarean section, either in labor or not in labor. BNP was measured in term and preterm FM, in culture cells, and conditioned media. We found BNP (but not ANP or CNP) inhibited contractions of preterm, but not term, human myometrium. BNP (both protein and mRNA) was detected in all tissues, conditioned media and cultured cells. BNP was higher in samples from preterm women not in labor compared to those at term not in labor. BNP concentrations were significantly reduced in women in spontaneous preterm labor. We conclude that locally produced BNP may be involved in generating myometrial quiescence during pregnancy. Further, a premature decrease of BNP production may cause preterm labor.
Assuntos
Membrana Corioalantoide/metabolismo , Miométrio/metabolismo , Peptídeo Natriurético Encefálico/biossíntese , Peptídeo Natriurético Encefálico/farmacologia , Contração Uterina/efeitos dos fármacos , Adulto , Biópsia , Feminino , Humanos , Técnicas In Vitro , Trabalho de Parto/metabolismo , Miométrio/efeitos dos fármacos , Peptídeo Natriurético Encefálico/genética , Gravidez , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Contração Uterina/fisiologia , Adulto JovemRESUMO
OBJECTIVE: To evaluate the secretion of interleukin 6 (IL-6) in cervicovaginal fluid in a pseudocohort that emulates the evolution of the labor. MATERIAL AND METHOD: Samples of cervicovaginal fluid of patients with 20 to 40 weeks of gestation were taken, patients were classified in 5 strata of the development of the labor. Each stratum reflects the progressive activation of the uterine activity and the cervical changes. To each sample was made determination of IL-6 by means of the system Multiplex. The samples of patient with infection data were eliminated. RESULTS: 173 samples were included distributed in each one of the five strata. Basal secretion exists of IL-6 to the cervicovaginal fluid along the gestation, that doesn't modify until the active labor appears. Only when the uterine activity is manifested in form to regulate and effective, very significant increase is documented in the concentration of the IL-6 in the cervicovaginal fluid. CONCLUSIONS: The IL-6 it is a proinflammatory cytokine that increases in a specific way in the moment in that the effective uterine activity begins, thus, it is an excellent candidate to be evaluated as marker presage of the event of normal labor and preterm.
Assuntos
Exsudatos e Transudatos/química , Interleucina-6/análise , Interleucina-6/metabolismo , Trabalho de Parto/metabolismo , Colo do Útero , Feminino , Humanos , Gravidez , VaginaRESUMO
BACKGROUND: Physiological and pathological membrane rupture is a complex phenomenon with different biochemical processes; it is known that collagenolitic activity rises and collagen content diminishes within term tissue membranes in comparison to preterm membranes. Identification of these processes within rupture mechanism allows to suggest that fetal membranes and decidua can respond to biochemical and mechanical stimulus alike, and to produce mediators that degrade matrix of intracellular membranes. OBJECTIVE: To identify simultaneously, whit a soluble microarray, different matrix metalloproteinases in extracts from amniochorion of pregnancies at term and preterm. PATIENTS AND METHODS: Biomedical experimental study where amniochorion explants were obtained from four women groups. Group 1: at term with spontaneous labor; group 2: at term without labor; group 3: at term with premature rupture of membranes, and group 4: preterm labor. Explants were cultured for 24 h and then homogenated in their own culture media to obtain cell free extracts. MMP were identified in these extracts using a soluble microarray for MMPs that included: MMP-1, -2, -3, -7, -8, -9, -12 and -13. RESULTS: MMP-8 and -2 were the enzymes most abundant in all the extracts of amniochorion. However, the concentration of MMP-8 in the extracts of group 3 (PROM) was significantly greater in comparison with the extracts of groups 1 and 2 (p = 0.01). The MMP-8 also was in greater concentration in the extracts of group 4 (preterm labor) in comparison with in the extracts of group 1 (p = 0.01). CONCLUSION: Activation of cellular processes that lead to the degradation of connective tissue in the MCA under physiological conditions seems to defer in originating tissues from cases with PROM or preterm labor, and this activation is characterized by an increase in the concentration of MMP-8.
Assuntos
Âmnio/química , Córion/química , Trabalho de Parto/metabolismo , Metaloproteinases da Matriz Secretadas/análise , Trabalho de Parto Prematuro/enzimologia , Feminino , Humanos , Análise em Microsséries , GravidezRESUMO
This research aims to measure the energy spending in parturient women of low gestation risk. Participants were selected randomly and submitted to fasting (n=15; Group I) or honey ingestion (n=15; Group II). Data were collected by means of capillary blood values and heart frequency monitoring. The paired t-test with a 5% significance level and Tukey's method were used in statistical analysis. The results showed that honey ingestion did not promote an overload in the mother's glucose; the lactate response demonstrated that the substrate offered was well used; the cardiorespiratory rate demonstrated good performance for both groups; the total energy spent during labor demonstrated that carbohydrate ingestion exerts significant influence, improving maternal anaerobic performance; the group which remained in fasting presented, immediately after labor, higher levels of lactate, showing the organism's efforts to compensate for the energy spent.
Assuntos
Glicemia/análise , Metabolismo Energético , Mel , Trabalho de Parto , Ácido Láctico/sangue , Adulto , Interpretação Estatística de Dados , Parto Obstétrico , Ingestão de Energia , Jejum , Feminino , Frequência Cardíaca/fisiologia , Humanos , Trabalho de Parto/metabolismo , Trabalho de Parto/fisiologia , Gravidez , Estudos ProspectivosRESUMO
The release of arachidonic acid from membrane glycerophospholipids through the action of phospholipases (PLs) is the first step in the biosynthesis of prostaglandins (PGs). In reproductive tissues, the most important PLs are cytosolic PLA(2) (cPLA(2)) and types IIA and V of the secretory isoform (sPLA(2)). The aim of this work was to investigate the role of ovarian steroid hormones and oxytocin (OT) in the regulation of rat uterine PLA(2) activity and expression during pregnancy and labor. The activity of sPLA(2) increased near labor, whereas cPLA(2) activity augmented towards the end of gestation. The levels of sPLA(2) IIA and cPLA(2) mRNA showed an increase before labor (P<0.05, day 21), whereas sPLA(2) V mRNA was not regulated during pregnancy. The administration of atosiban (synthetic OT antagonist) together with tamoxifen (antagonist of estrogen receptors) was able to decrease cytosolic and secretory PLA(2) activities, diminish the expression of sPLA(2) IIA and cPLA(2), as well as decrease PGF(2 alpha) production before the onset of labor (P<0.01). The ovarian steroid did not affect PLA(2) during pregnancy. Collectively, these findings indicate that in the rat uterus, both 17beta-estradiol and OT could be regulating the activity and the expression of the secretory and the cytosolic isoforms of PLA(2), thus controlling PGF(2 alpha) synthesis prior to the onset of labor.
Assuntos
Estradiol/fisiologia , Isoenzimas/metabolismo , Trabalho de Parto/metabolismo , Ocitocina/fisiologia , Fosfolipases A2/metabolismo , Útero/enzimologia , Animais , Citosol/enzimologia , Dinoprosta/biossíntese , Dinoprosta/metabolismo , Estradiol/sangue , Antagonistas de Estrogênios/farmacologia , Feminino , Expressão Gênica/efeitos dos fármacos , Isoenzimas/genética , Mifepristona/farmacologia , Ocitocina/sangue , Fosfolipases A2/genética , Gravidez , Progesterona/antagonistas & inibidores , Progesterona/metabolismo , Ratos , Ratos Wistar , Receptores de Ocitocina/antagonistas & inibidores , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tamoxifeno/farmacologia , Útero/efeitos dos fármacos , Vasotocina/análogos & derivados , Vasotocina/farmacologiaRESUMO
The induction of the expression of matrix metalloproteinases (MMPs) and their extracellular activation are key processes in connective tissue degradation in the chorioallantoid membrane during rat labour. However, the regulatory mechanisms remain largely unknown. Here, we report the identification of a calcium-dependent high molecular weight complex composed of MMP-9, MMP-3, MMP-2, tissue inhibitor of metalloproteinase 1 (TIMP-1) and TIMP-2, identified by zymography and western blotting. Molecular sieve chromatography confirmed the presence of a complex of MMPs and TIMPs with an exclusion volume >670 kDa. Differential scanning calorimetry of the complex confirmed the existence of a macromolecular complex that unfolds with a broad transition; it is denatured over a wide range of temperatures and has a T(m) of 72 degrees C in the presence of Ca(2+). When denatured in the absence of Ca(2+), there were at least eight transitions with T(m)s that corresponded to pro-MMP-9, MMP-9, pro-MMP-3, MMP-3, pro-MMP-2, MMP-2, TIMP-1 and TIMP-2. Co-localization of the same molecular components was demonstrated by confocal microscopy using cell-depleted chorioallantoid membranes. The assembly and disassembly of the complex can be reproduced at physiological concentrations of Ca(2+). This complex provides a potential mechanism for the enzymatic regulation of MMPs, which may participate in connective tissue degradation leading to the rupture of the fetal membranes during labour.
Assuntos
Cálcio/metabolismo , Membrana Corioalantoide/enzimologia , Trabalho de Parto/metabolismo , Metaloproteinases da Matriz Secretadas/análise , Complexos Multienzimáticos/química , Animais , Western Blotting , Varredura Diferencial de Calorimetria , Quelantes , Cromatografia em Gel , Ácido Edético , Eletroforese em Gel de Poliacrilamida , Feminino , Metaloproteinase 2 da Matriz/análise , Metaloproteinase 3 da Matriz/análise , Metaloproteinase 9 da Matriz/análise , Metaloproteinases da Matriz Secretadas/metabolismo , Microscopia Confocal , Complexos Multienzimáticos/metabolismo , Gravidez , Desnaturação Proteica , Ratos , Ratos Wistar , Inibidor Tecidual de Metaloproteinase-1/análise , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Inibidor Tecidual de Metaloproteinase-2/análise , Inibidor Tecidual de Metaloproteinase-2/metabolismoRESUMO
Extracellular matrix degradation in fetal membranes leading to its rupture is coupled to myometrial activity and cervical ripening during human normal labor. Mechanisms which modulate collagen degradation in amniochorion during labor have not been elucidated. Initial characterization of the effect of different blood compartments on connective tissue degradation in amniochorion during human labor was explored. Amniochorion explants were stimulated with plasma of maternal venous blood, umbilical cord blood or placental blood, obtained from women with pregnancies at term, with or without labor. MMP-2 and MMP-9 activities were quantified in conditioned media by gelatin-zymography as an index of connective tissue degradation. Collagen content was measured in tissue explants and collagen fibrils distribution was examined by electron microscopy. Placental plasma from term pregnancies, with or without labor, is enriched with soluble signals that enhance the in vitro MMP-9 production by amniochorion. Accompanying ultrastructural distortion of collagen fibers and demonstration of collagen degradation fragments confirmed induction of extracellular matrix degradation. Control experiments in which MMP-9 activity was blocked with TIMP-1 resulted in inhibition of all the above mentioned changes. These results suggest that placental intervillous space is a functional compartment in which mediators capable to induce collagen degradation in amniochorion are selectively expressed during human labor.
Assuntos
Âmnio/metabolismo , Córion/metabolismo , Tecido Conjuntivo/metabolismo , Trabalho de Parto/metabolismo , Âmnio/citologia , Âmnio/enzimologia , Córion/citologia , Córion/enzimologia , Tecido Conjuntivo/enzimologia , Feminino , Humanos , Contagem de Leucócitos , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismo , Gravidez , Técnicas de Cultura de TecidosRESUMO
We have previously reported that intrauterine (i/u) administration of epidermal growth factor (EGF 500 ng) on day (d) 21 of pregnancy delayed 19.0 +/- 0.6 h the onset of labor. Progesterone (P) is secreted by ovarian corpora lutea (CL) throughout gestation in the rat. Prepartum CL regression due to increased uterine cyclooxygenase I and prostaglandin F(2alpha) results in P withdrawal followed by labor. The aims of the present work were (i) to study whether EGF delayed-onset of labor was mediated by a mechanism that prevented CL regression; (ii) to determine amniotic fluid (AF) EGF in pregnant rats. Rats on d21 of pregnancy received i/u EGF (500 ng) and were killed 0, 4, 8, 12, 24, and 48 h later. Control AF from rats on d13 and 18-22 of pregnancy was obtained. EGF decreased uterine prostaglandin F(2alpha) synthesis 8 h after treatment. Twelve hours after EGF injection, P reached its highest serum level and uterine cyclooxygenase I expression was undetectable. CL from rats killed 8 and 12 h after EGF were similar to those from rats on d13 of pregnancy, when serum P is maximum. EGF in AF increased throughout gestation, reached a maximum on d21, and decreased before the onset of labor. We suggest that the effect of EGF on the onset of labor was mediated by an early effect on the uterus that prevented prepartum CL regression.