[The cesarean section scar and subsequent labor. III. Revision of the uterus--possibilities of ultrasonography in the early puerperium--an algorithm for management of labor].
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Female↗
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[Role of the Department of Labor Hygiene in the training of personnel and the development of hygienic science (on the 50th anniversary of the Department of Labor Hygiene of the I. M. Sechenov 1st Moscow Medical Institute)].
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History of Medicine↗
Labor shortage or cheap labor?
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Dental Hygienists↗
[Foreign laborers in Germany--an evaluation of occupational health screening of foreign laborers for determining health disorders].
The following article reports on an analysis of 257,064 medical examination data provided by the German Industrial Engineering and Traffic Safety Control organization, a service of industrial medicine. In addition to the occurrence of diseases (ICD-classification), correlations between the age, sex, nationality and occupations (ILO-classification) are shown, including occupational importance and need for continuing medical treatment. It could be demonstrated that there are different areas of regarding diseases when comparing foreign and German workers, based on places of work, and on social and cultural factors.
Adult↗
[Unusual case of post-labor leukopenia with manifestations of shock after labor].
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Anaphylaxis↗
Fasting in labor: relic or requirement.
OBJECTIVE: To evaluate the scientific literature on restrictions of eating and drinking during labor. DATA SOURCES: Computerized searches in MEDLINE and CINAHL, as well as historical articles, texts, and references cited in published works. Key words used in the searches included anesthesia in labor, childbirth, eating and drinking, epidural, fasting, fasting in labor, fasting and pregnancy, gastric aspiration, gastric emptying, intrapartum, intravenous fluids, i.v.s in labor, ketonuria, ketonuria in labor, parturition, pregnancy, and stomach contents in labor. STUDY SELECTION: Articles from indexed journals, excluding single-person case studies. DATA EXTRACTION: Data were extracted and organized under the following headings: historical review, effects of fasting on labor, research on maternal mortality/morbidity from aspiration, research on gastric emptying in labor, intravenous hydration in labor, and implications for nursing research. DATA SYNTHESIS: Research does not support restricting food and fluids in labor to prevent gastric aspiration. Restricting oral intake during labor has unexpected negative outcomes. CONCLUSIONS: Little is known about the differences in labor progress, birth outcomes, and neonatal status between mothers who consume food and/or fluids during labor and women who fast during labor. Research also is needed on the effects of epidural opioids on gastric emptying, nutritional requirements during labor, and the physiologic implications of fasting during labor. Fasting during labor is a tradition that continues with no evidence of improved outcomes for mother or newborn. Many facilities (especially birth centers) do not restrict eating and drinking. Across the United States, most hospitals restrict intake, usually to ice chips and sips of clear liquids. Anesthesia studies have focused on gastric emptying, measured by various techniques, presuming that delayed gastric emptying predisposes women to aspiration. Narcotic analgesia delays gastric emptying, but results are conflicting on the effect of normal labor and of epidural anesthesia on gastric emptying. The effect of fasting in labor on the fetus and newborn and on the course of labor has not been studied adequately. Only one study evaluated the probable risk of maternal aspiration mortality, which is approximately 7 in 10 million births.
Fasting↗
The impact of diagnosis and treatment of rectal cancer on paid and unpaid labor.
PURPOSE: This study was designed to describe the consequences of diagnosis and treatment of rectal cancer for paid and unpaid labor over time and to identify sociodemographic-related factors, treatment-related factors, and quality of life-related factors associated with paid and unpaid labor. METHODS: Data were assessed prospectively in two samples of patients with primary rectal cancer, participating in a multicenter clinical trial, who were randomized to receive surgery with or without 5 x 5-Gy preoperative radiotherapy. For paid labor, 292 patients who indicated paid labor before treatment filled out quality of life questionnaires, which included questions on paid labor at 3, 6, 12, 18, and 24 months after surgery. For unpaid labor, another sample of 92 patients also filled out the Health and Labor questionnaire, which included questions on unpaid labor, before treatment, and at 3 and 12 months after treatment. RESULTS: From 3 to 18 months after surgery, paid labor resumption increased from 19 to 63 percent (P < 0.001). At 24 months after surgery, paid labor resumption was 61 percent. In a multivariate analysis, age older than 55 years (P <or= 0.001), lower education level (P <or= 0.003), shorter time since surgery (P < 0.001), preoperative radiotherapy (P = 0.02), lower valuation of overall health (P < 0.01), more physical symptom distress (P < 0.001), and more limitations in daily activities (P < 0.001) were all associated with less or later resumption of paid labor. The average amount of unpaid labor increased from 17.3 hours per week at 3 months to 21 hours per week at 12 months after surgery. In a multivariate analysis, only shorter time since surgery (P = 0.03) and male gender (P < 0.001) were related to less unpaid labor. CONCLUSIONS: Diagnosis and treatment of rectal cancer affect paid and unpaid labor. The impact on paid labor is most pronounced. Multiple other sociodemographic and quality of life-related variables also were associated with paid labor. Patient information and decision making on preoperative radiotherapy should include the effects on paid labor, and interventions focused on promoting paid labor participation in patients with rectal cancer should be tailored to the specific characteristics and needs of those patients.
Aged↗
Comparison of labor progression between induced and noninduced multiparous women.
OBJECTIVE: The incidence of labor induction is rising rapidly in the United States. Among multiparas, labor is often followed with traditional labor curves derived from noninduced pregnancies. We sought to determine how labor progression of multiparous women who presented in spontaneous labor differed from those who were electively induced with and from those induced without preinduction cervical ripening. METHODS: We analyzed data on all low-risk multiparous women with an elective induction or spontaneous onset of labor between 37(+0) and 40(+6) weeks of gestation from January 2002 to March 2004 at a single institution. The median duration of labor by each centimeter of cervical dilatation and the risk of cesarean delivery were computed for 61 women with preinduction cervical ripening and oxytocin induction, 735 women with oxytocin induction, and 1,885 women with a spontaneous onset of labor. An intracervical Foley catheter was used to ripen the cervix. RESULTS: Those women who experienced electively induced labor without cervical ripening had a shorter active phase of labor than did those admitted in spontaneous labor (99 minutes in induced labor versus 161 minutes in spontaneous labor, P < .001). However, the cesarean delivery rate was elevated in the induction group (3.9% versus 2.3%, P < .05). Women who underwent preinduction cervical ripening also had a shorter active phase than those admitted in spontaneous labor (109 minutes versus 161 minutes, P = .01). CONCLUSION: The pattern of labor progression differs for women with an electively induced labor without cervical ripening compared with those who present with spontaneous onset of labor.
Adult↗
High levels of fetal membrane activin beta A and activin receptor IIB mRNAs and augmented concentration of amniotic fluid activin A in women in term or preterm labor.
The aim of the present study was to evaluate whether spontaneous labor at term and pathological preterm labor are associated with changes in the expression of activin A and activin receptor mRNAs in fetal membranes. In addition, amniotic fluid activin A concentration in women delivering at term or undergoing preterm labor was also measured. The expression of activin beta A subunit and activin receptor type II and type IIB mRNAs was assessed by reverse transcriptase-PCR on specimens of amnion and chorion collected from patients delivering at term or undergoing preterm labor. Control specimens were collected from women delivered by elective cesarean section who had not experienced labor. A specific two-site ELISA was used to measure activin A concentrations in the amniotic fluid. A cross-sectional study of amniotic fluid retrieved by amniocentesis from 109 pregnant women was carried out. Patients were classified into the following groups: (1) healthy controls at term but not in labor (n = 25); (2) healthy controls at term in spontaneous labor (n = 40); (3) healthy controls between 23 and 36 weeks of gestation (n = 12); (4) patients in preterm labor responding to tocolytic treatment (n = 19); (5) patients in preterm labor with subsequent delivery (n = 13). Activin beta A subunit and activin receptor type IIB mRNA levels in both the chorion and amnion in women delivering at term or after preterm labor were significantly higher than in women delivering without undergoing labor (P < 0.01). Expression of activin receptor type II mRNA in membranes did not differ among the three groups of women. Amniotic fluid activin A concentration in patients in labor was significantly higher than in those at term but not in labor (P < 0.01). Patients in preterm labor had significantly higher amniotic fluid activin A concentrations than women at the same stage of gestation (P < 0.01). The highest values were found in women undergoing preterm labor and subsequent delivery. In conclusion, spontaneous labor and preterm labor are characterized by increased synthesis and release of activin A from amniotic and chorionic cells and by an augmented expression of activin type IIB receptor.
Activin Receptors↗
Reevaluation of Friedman's Labor Curve: a pilot study.
OBJECTIVE: To reevaluate the average length of each phase/stage of labor for multiparous and primiparous women in North America who received no regional anesthesia or oxytocin augmentation or induction, to describe a range of labor lengths associated with good childbirth outcomes, and to determine if there is a consensus among labor and delivery nurse managers responding to the survey regarding the need to revise Friedman's Labor Curve. DESIGN: This pilot study used a descriptive and anonymous cross-sectional survey design. Surveys were mailed to 500 maternity care agencies in the United States, Canada, and Mexico with a return rate of 17.8% (n = 89). Each participating agency was asked to submit five patient cases to be included in the analysis. SAMPLE AND SETTING: The sample of patient cases (n = 419) was drawn from randomly selected maternity care agencies throughout North America representing all sizes of agencies and geographic locations. The cases submitted for analysis represented women 14 to 44 years of age with varying ethnicities who received no regional anesthesia or oxytocin augmentation or induction. Twenty-three percent of the women in the sample (n = 97) were primigravidas. RESULTS: The average length of labor for primiparous and multiparous women today is similar to the average length of labor described by Friedman in 1954. However, a wider range of "normal" was found in cases included in the current study. Primiparous women remained in the first stage of labor for up to 26 hours and the second stage of labor up to 8 hours with no adverse effects to mother or infant. Multiparous women remained in the first stage of labor for up to 23 hours and the second stage of labor for up to 4.5 hours with good birth outcomes. In addition, 87.6% of nurse managers responding to the survey believed that Friedman's Labor Curve should be revised to meet the needs of current patient populations, technological advances, and nursing responsibilities. CONCLUSIONS: This study suggests that the parameters to determine if a labor is progressing satisfactorily may need to be expanded. With the availability of technology to assess maternal and fetal well-being, labor should be allowed to progress past the rigid 2-hour time limit for the second stage of labor artificially imposed on women in some childbirth settings. More emphasis should be placed on the nursing assessment techniques used to reassure the family and health care practitioners that labor is progressing safely and the nursing interventions that may have an impact on the length of each stage of labor.
Adolescent↗
Obstetric outcome of patients with a previous episode of spurious labor.
The obstetric performance of patients admitted with spurious labor was evaluated. The incidence of fetal distress in labor was significantly higher in those who had spurious labor (16.7%) than in those who were established in labor within 24 hours of admission (3.8%). An equivocal or ominous fetal heart rate trace on admission was related to the occurrence of fetal distress in labor in both the spurious labor group and the normal labor group. Positive predictive value of a normal test was low in the spurious labor group. Obstetric interventions such as augmentation (35.7%) and operative deliveries (41.0%) were significantly higher in the spurious labor group than in the normal labor group (19.7% and 18.8%, respectively). The induction rate in the spurious labor group was 15.5%. The use of oxytocin for augmentation and induction of labor seems to contribute to the increased incidence of fetal distress and operative deliveries in the spurious labor group. The spurious labor group also had a higher incidence of fetal distress than the control group even among the patients who did not receive oxytocin. The results suggest that patients with an episode of spurious labor constitute a high-risk group with a considerable risk of fetal distress and obstetric interventions in subsequent labor.
Delivery, Obstetric↗
Risk of uterine rupture during labor among women with a prior cesarean delivery.
BACKGROUND: Each year in the United States, approximately 60 percent of women with a prior cesarean delivery who become pregnant again attempt labor. Concern persists that a trial of labor may increase the risk of uterine rupture, an uncommon but serious obstetrical complication. METHODS: We conducted a population-based, retrospective cohort analysis using data from all primiparous women who gave birth to live singleton infants by cesarean section in civilian hospitals in Washington State from 1987 through 1996 and who delivered a second singleton child during the same period (a total of 20,095 women). We assessed the risk of uterine rupture for deliveries with spontaneous onset of labor, those with labor induced by prostaglandins, and those in which labor was induced by other means; these three groups of deliveries were compared with repeated cesarean delivery without labor. RESULTS: Uterine rupture occurred at a rate of 1.6 per 1000 among women with repeated cesarean delivery without labor (11 women), 5.2 per 1000 among women with spontaneous onset of labor (56 women), 7.7 per 1000 among women whose labor was induced without prostaglandins (15 women), and 24.5 per 1000 among women with prostaglandin-induced labor (9 women). As compared with the risk in women with repeated cesarean delivery without labor, uterine rupture was more likely among women with spontaneous onset of labor (relative risk, 3.3; 95 percent confidence interval, 1.8 to 6.0), induction of labor without prostaglandins (relative risk, 4.9; 95 percent confidence interval, 2.4 to 9.7), and induction with prostaglandins (relative risk, 15.6; 95 percent confidence interval, 8.1 to 30.0). CONCLUSIONS: For women with one prior cesarean delivery, the risk of uterine rupture is higher among those whose labor is induced than among those with repeated cesarean delivery without labor. Labor induced with a prostaglandin confers the highest risk.
Adolescent↗
Elective induction of labor: a prospective clinical study, II: Psychological effects.
Several authors have stated that induction of labor may have deleterious psychological effects on women's experiences of labor and early mother-infant interaction. Research on this subject is scarce and in most cases no distinction is made between elective induction and induction for medical reasons. For that reason the observed effects may also have been caused by the medical complications that led to the induction. Differences in experience of labor may also be in part explained by differences in personal characteristics between women choosing or rejecting induction of labor. Influences of induction of labor can only be reliably assessed in prospective studies. In the present study of 271 women with an uncomplicated pregnancy, data regarding their experiences of pregnancy and their expectations of labor and motherhood were collected before labor. In 72 women labor was electively induced, and 199 women had a spontaneous onset of labor. Of 33 women, 19 with spontaneous labor and 14 with elective induction, the first contact with their newborn was observed. All women who could be contacted were interviewed about their experience of labor and the first contact with their infant. Six months after delivery the mothers were questioned about the state of health of mother and infant and about nursing the infant. Mothers with induced labor were rated as being generally less emotionally involved in the first contact with their newborn than mothers with spontaneous labor, but the differences were not significant (Fig. 1). The duration of spontaneous labor was longer, but the subjective time experience did not differ between groups. Women with spontaneous labor were more tired during labor.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Oxytocin and initiation of human parturition. III. Plasma concentrations of oxytocin and 13,14-dihydro-15-keto-prostaglandin F2 alpha in spontaneous and oxytocin-induced labor at term.
The plasma concentrations of oxytocin and 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) were measured in serial samples collected during the first stage of spontaneous and oxytocin-induced labor in 17 and 15 women, respectively. Four women in late pregnancy served as control subjects, with serial samples collected at similar intervals as during labor. During spontaneous labor, mean plasma oxytocin levels were consistently raised over the levels observed 1 to 2 weeks before the onset of labor and were higher than the levels in the control patients (mean, 19.9 +/- 3.1 pg/ml) and the initial levels in the oxytocin-induced group of women (mean, 17.4 +/- 4.8 pg/ml). The mean plasma oxytocin levels during spontaneous labor (45 +/- 3.9 pg/ml) were similar to those observed during infusion of 4 to 6 mU/min of synthetic oxytocin (49.1 +/- 10.9 pg/ml). Plasma oxytocin levels increased progressively with stepwise increments of the infusion. Plasma PGFM levels also rose during labor, but, in contrast to the oxytocin levels which increased in early labor, plasma PGFM levels did not increase significantly until relatively late in labor, provided the membranes were intact. The state of the membranes had a marked influence on plasma PGFM; patients with spontaneous rupture of membranes had significantly increased PGFM levels when admitted early in labor or when membranes ruptured during labor. This increase in prostaglandin F2 alpha (PGF2 alpha) production does not by itself suffice to initiate labor, as evidenced by the failure of premature rupture of the membranes to initiate labor in a number of patients with elevated PGFM levels in whom labor was then induced with oxytocin. Conversely, oxytocin induction was successful only when PGFM levels increased during the infusion of oxytocin; in the absence of a rise in plasma PGFM, oxytocin induction failed. These data add support to the view that both oxytocin and PGF2 alpha are required for adequate stimulation of the human uterus during labor. In addition, the data suggest that oxytocin rather than PGF2 alpha may be the major stimulus that initiates labor, whereas PGF2 alpha appears responsible for the progress of labor.
Cervix Uteri↗
Traumatic experience with vacuum extraction--influence of personal preparation, physiology, and treatment during labor.
OBJECTIVE: To assess pre-labor attitudes and post-labor experiences of the use of vacuum extraction during delivery. To seek associations between traumatic labor experience and personal preparation, physiology of labor and treatment during labor. METHODS: A total of 205 women filled in a questionnaire within five days of vacuum extraction delivery. The questionnaire was designed to distinguish the group of women having experienced their labor as traumatic from those not having such an experience. The association between explanatory variables grouped as background factors, physiological factors of labor and treatment-related factors in relation to traumatic experience status was studied by bivariate analysis by the chi-square test or Student's t-test. Logistic regression analysis was carried out to examine simultaneous effects of factors. In the first phase, each of the previously chosen groups was analyzed separately, and in the second, all risk factors thus emerging as significant were entered into the final model. RESULTS: Forty-two women (20%) regarded their childbirth experience as traumatic. Of the background factors, insufficient pre-labor training and a pre-labor desire for extra strong pain relief during the coming labor were significantly more common in the traumatic birth group. Of the physiological factors of labor, unsatisfactory pain relief and a difficult third stage of labor were associated with a traumatic birth experience. The treatment-related factors showed mutual correlation and were strongly associated with birth experience. After logistic regression analysis only four independent risk factors emerged as significant: insufficient support immediately after delivery, the experience of being poorly listened to during labor, insufficient doctor's support during the first stage of labor, and pre-labor training classes considered insufficient. CONCLUSIONS: Treatment-related factors were the most powerful predictors of an adverse birth experience after vacuum extraction delivery, exceeding those related to labor physiology. Thus, the role of treatment and care before, during and after vacuum extraction is emphasized.
Adult↗
Maternal satisfaction with active management of labor: a randomized controlled trial.
BACKGROUND: Active management of labor reduces the length of labor and rate of prolonged labor, but its effect on satisfaction with care, within a randomized controlled trial, has not previously been reported. The study objectives were to establish if a policy of active management of labor affected any aspect of maternal satisfaction, and to determine the independent explanatory variables for satisfaction with labor care in a low-risk nulliparous obstetric population. METHODS: Nulliparous women at National Women's Hospital in Auckland, New Zealand, in spontaneous labor at term with singleton pregnancy, cephalic presentation, and without fetal distress were randomized after the onset of labor to active management (n = 320) or routine care (n = 331). Active management included early amniotomy, two-hourly vaginal assessments, and early use of high dose oxytocin for slow progress in labor. Routine care was not prespecified. Maternal satisfaction with labor care was assessed by postal questionnaire at 6 weeks postpartum. Sensitivity analyses were performed, and logistic regression models were developed to determine independent explanatory variables for satisfaction. RESULTS: Of the 651 women randomized in the trial, 482 (74%) returned the questionnaires. Satisfaction with labor care was high (77%) and did not significantly differ by treatment group. This finding was stable when sensitivity analysis was performed. The first logistic regression model found independent associations between satisfaction and adequate pain relief, one-to-one midwifery care, adequate information and explanations by staff, accurate expectation of length of labor, not having a postpartum hemorrhage, and fewer than three vaginal examinations during labor. The second model found fewer than three vaginal examinations and one-to-one midwifery care as significant explanatory variables for satisfaction with labor care. CONCLUSIONS: Active management did not adversely affect women's satisfaction with labor and delivery care in this trial. Future studies should concentrate on measurement of potential predictors before and during labor.
Adult↗
Prostaglandin endoperoxide H synthase (PGHS) activity and PGHS-1 and -2 messenger ribonucleic acid abundance in human chorion throughout gestation and with preterm labor.
Term and preterm parturition is associated with elevated intrauterine PG production. Although an increase of PG synthesis by the fetal membranes during term labor is well documented, there is little data available regarding the prostanoid production of these tissues at term, before the spontaneous onset of labor. In the present study, we determined the expression of PG H2 synthase (PGHS), the committing and rate-limiting enzyme of prostanoid biosynthesis, in the chorion laeve during gestation. Tissues were collected from 18 patients at term (37-41 weeks of gestation) and from 13 patients between 17 and 35 weeks of pregnancy. None of the patients were in labor. PGHS-specific activity and the abundance of messenger RNAs (mRNAs) encoding the two PGHS isoenzymes (the constitutive PGHS-1 and the inducible PGHS-2) were measured by a cell-free enzyme assay and specific ribonuclease protection assays, respectively. PGHS-specific activity as well as PGHS-1 and -2 mRNA levels were significantly (P < 0.01) higher at term before labor than earlier during gestation. Furthermore, PGHS activity at term exhibited significant positive correlation with PGHS-2 mRNA levels, but not with PGHS-1 mRNA levels. In situ hybridization indicated that the expression of both PGHS mRNAs increased in the epithelial and the mesenchymal cells of the amnion and the chorion laeve at term. Additionally, PGHS activity and mRNA levels were determined in the chorion laeve of a group of patients who gave birth spontaneously before term (30.6 +/- 1 weeks, mean +/- SEM, n = 5), and the values were compared with a group who delivered by cesarean section before labor at a similar gestational age (31.9 +/- 1.4 weeks, n = 5, P > 0.05 vs. the preterm labor group). None of the patients exhibited signs of genital tract infection. PGHS-specific activity and PGHS-1 and -2 mRNA levels were significantly higher in the preterm labor group than in the group who delivered preterm without labor. In situ hybridization suggested that the enhanced PGHS-1 and -2 mRNA expression occurred predominantly in the mesenchymal cells of the fetal membranes at preterm labor. Thus, PGHS-1 and -2 expression increases in the chorion laeve at term before labor, with PGHS-2 as the functionally prevalent isoform. This supports the possibility that PGs originating in the fetal membranes promote the onset of normal labor. Furthermore, preterm labor is associated with the elevated expression of the two PGHS isoenzymes in the chorion laeve. The maturation of the fetal membranes in preparation for term labor involves both the epithelial and the mesenchymal cells, whereas preterm labor is accompanied by the maturation of the mesenchymal tissue components, as reflected by PGHS expression. This difference may have implications in the early recognition of preterm labor.
Adult↗
Human myometrial genes are differentially expressed in labor: a suppression subtractive hybridization study.
Human parturition is effected by a cascade of factors, of which many are unknown. We aim to identify the genes that are changed by labor in the human myometrium by suppression subtractive hybridization. We also seek to ascertain whether these genes are differentially expressed in the myometrium at the upper or fundal and lower segments of the uterus. Term myometrial tissues were obtained from laboring and nonlaboring women undergoing cesarean section after obtaining informed consent. Total RNA was used in suppression subtractive hybridization (CLONTECH PCR Select) to produce two subtracted cDNA libraries enriched for genes expressed during or before labor, labor and not-in-labor libraries, respectively. Dot blot screening of 400 positive clones, constituting 20% of the two subtracted libraries, revealed 30 differentially expressed clones, 14 of which were up-regulated by labor. Among the 10 known genes that were up-regulated in labor, 6 had apparent immune regulatory and inflammatory roles. Three are well-known inflammatory mediators and modulators that were previously linked with parturition: IL-8, manganese superoxide dismutase (MnSOD), and metalloproteinase-9. Three others, interferon-inducible 1-8d gene, elongation factor 1alpha, and nucleophosmin, have not been previously linked with labor. Constitutively expressed genes, including cyclophilin and alpha-actin, were found to be altered by labor. Quantitative real-time RT-PCR using Taqman probes further confirmed the up-regulation of some of these genes. The amounts of the specific genes assayed were standardized to 18S ribosomal RNA and are expressed as mean +/- SEM. Quantitative real-time RT-PCR showed that IL-8 mRNA rose from 0.003 +/- 0.002 in nonlaboring samples (n = 38) to 0.24 +/- 0.11 (n = 20) in gestational-age-matched spontaneously laboring women (P = 0.035). Similarly, MnSOD rose from 0.11 +/- 0.02 (n = 24) to 1.23 +/- 0.56 (n = 24) in gestational-age-matched women (P = 0.047). Additionally, cyclophilin, often used as a constitutive or housekeeping gene marker, increased from 0.0008 +/- 0.0002 (n = 6) to 0.002 +/- 0.0004 (n = 6; P = 0.008) during labor. Notably, MnSOD mRNA was differentially distributed between the upper (0.63 +/- 0.18) and lower (0.15 +/- 0.05; n = 15; P = 0.022) segments of the uterus, but IL-8 was not (n = 17; P = 0.97). Induced labor further showed significantly higher levels of IL-8 (0.63 +/- 0.21; n = 14) than spontaneous labor (0.22 +/- 0.11; n = 20; P = 0.046), but not MnSOD (P = 0.1). This work identifies novel as well as known genes that were not previously associated with parturition. It extends previous data indicating that there is differential expression of some, but not all genes within the gravid human uterus. Inflammatory genes constitute a major proportion of the known genes found to be up-regulated in labor, lending support to the hypothesis of an inflammatory mechanism for human parturition. This work further indicates that many factors associated with human labor and their complex interactions remain to be elucidated.
Computer Systems↗