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PubMed2005

Incarceration of the retroverted gravid uterus: the key to successful treatment.

INTRODUCTION: Incarceration of the retroverted gravid uterus is rare, and it is difficult to make a diagnosis, and, therefore, difficult to treat. We present two cases of incarceration of the retroverted gravid uterus. CASE REPORT: Two pregnant women presented with urinary retention at 14 weeks' gestation. We tried to push the gravid uterus upward, but in the end the two women underwent cesarean section. In one of the women it was possible to relieve incarceration of the retroverted gravid uterus. CONCLUSION: There was no sign of endometriosis in these pregnancies, which is important to evaluate when pregnant women have a complication.

Adult↗

PubMed2006

Family members serving the gestational carrier needs of women lacking a uterus: a report of two cases.

CASE REPORT: In two instances, a designated relative served as a gestational carrier for a woman who no longer had a uterus. In the first case, a 38-year-old woman underwent an emergency cesarean hysterectomy due to worsening fatty degeneration of the liver in the third trimester, culminating in massive hemorrhage, consumptive coagulopathy and the loss of twins at 28 weeks gestation following successful in vitro fertilization. In the second case, a 28-year-old had congenital absence of the uterus and vagina. Both surrogates volunteered for service and were carefully screened medically, reproductively, and psychosocially prior to proceeding. All parties were required to execute informed consent and contracts with private attorneys before entry. Both gestational carriers conceived following the initial embryo transfer; one as the result of previously cryopreserved embryos, the other from embryos obtained following the synchronized in vitro fertilization of newly aspirated oocytes. Gestational carriers were prescribed oral estradiol and vaginal progesterone to prepare the uterus for implantation, and maintained this regimen throughout the first trimester of pregnancy. The pregnancies proceeded uneventfully and resulted in the delivery of singleton births at term. Both infants were formally adopted after delivery by the genetic parents in compliance with the advice of counsel under New York State law. CONCLUSION: Family members serving as gestational carriers provide women with functional ovaries but no uterus, the opportunity to have genetic offspring, while avoiding much of the high cost and social uncertainty of commercial surrogates.

Adult↗

PubMed1999

Cholinergic neurons of the pelvic autonomic ganglia and uterus of the female rat: distribution of axons and presence of muscarinic receptors.

Acetylcholine (ACh) stimulates contraction of the uterus and dilates the uterine arterial supply. Uterine cholinergic nerves arise from the paracervical ganglia and were, in the past, characterized based on acetylcholinesterase (AChE) histochemistry. However, the histochemical reaction for acetylcholinesterase provides only indirect evidence of acetylcholine location and is a nonspecific marker for cholinergic nerves. The present study: (1) reevaluated cholinergic neurons of the paracervical ganglia, (2) examined the cholinergic innervation of the uterus by using retrograde axonal tracing and antibodies against molecules specific to cholinergic neurons, choline acetyltransferase and the vesicular acetylcholine transporter, and (3) examined muscarinic receptors in the paracervical ganglia using autoradiography and a radiolabeled agonist. Most ganglionic neurons were choline acetyltransferase- and vesicular acetylcholine transporter-immunoreactive and were apposed by choline acetyltransferase/vesicular acetylcholine transporter-immunoreactive terminals. Retrograde tracing showed that some cholinergic neurons projected axons to the uterus. These nerves formed moderately dense plexuses in the myometrium, cervical smooth muscle and microarterial system of the uterine horns and cervix. Finally, the paracervical ganglia contain muscarinic receptors. These results clearly reveal the cholinergic innervation of the uterus and cervix, a source of these nerves, and demonstrate the muscarinic receptor content of the paracervical ganglia. Cholinergic nerves could play significant roles in the control of uterine myometrium and vasculature.

Acetylcholinesterase↗

PubMed1984

Imaging the pregnant human uterus with nuclear magnetic resonance.

Nuclear magnetic resonance (NMR) techniques have been used to produce images of the pregnant and nonpregnant human uterus. A series of pictures is presented showing the normal nonpregnant uterus and pelvic organs, the uterus and its contents in pregnancy at 17, 30, and 40 weeks' gestation, and the pelvic organs in the early puerperium. In early pregnancy the uterus and placenta are clearly seen and the dimensions and configuration of the pelvis can be readily assessed. Because of the relatively long scan time of 2 minutes, better images of the fetus were obtained in the third trimester when movement is more restricted. The potential value of this technique in obstetrics is discussed.

Female↗

PubMed1985

Incisions of the pregnant uterus and delivery of low-birth weight infants.

This paper calls attention to rapidly increased use of vertical uterine incision and future consequences: impaired uterus, uterine rupture, and iatrogenic premature delivery. In addition, by making a vertical uterine incision we are not gaining much in the size of uterine entrance since the size of the vertical uterine incision is determined by uterine tonus. Most often the uterus is opened by tearing the lower uterine segment transversely with the fingers. Unfortunately this creates the smallest entrance to the uterus because of the uterine structure, shape, and elasticity and could lead to parametrial vein and uterine vessel injury. An alternative to this type of incision is the durable upward curved transverse incision over the supportive lower uterine segment. This technique gives us the biggest entrance to the uterus, without serious side effects, and ensures safe future pregnancies.

Cesarean Section↗

PubMed1986

Heat flux and oxygen consumption of the pregnant uterus.

Heat flux (conductive and convective heat) and oxygen consumption of the pregnant uterus and its content were measured simultaneously in the same group of pregnant ewes during the acute postoperative period, during a chronic resting period, and during alpha- and beta-adrenergic-receptor stimulation with norepinephrine and ritodrine. Results indicated four conclusions. First, an excellent correlation existed between heat flux and oxygen consumption in the acute and chronic resting condition as well as during increasing uteroplacental vascular resistance and decreasing blood flow produced by norepinephrine infusion; the correlation was not as good during ritodrine infusion. Second, during rest, about 85% of heat generated by the pregnant uterus is eliminated through the uteroplacental circulation while the remaining heat diffuses through the myometrium. Third, during decreasing uteroplacental blood flow and elevated resistance, the pregnant uterus is able to maintain a normal thermostasis by widening the temperature difference in the blood entering and leaving the uterus and by increasing the myometrial heat exchange; oxygen consumption also is maintained at normal level through increase in oxygen extraction. Fourth, with the exception of uteroplacental circulation, the circulatory, metabolic, and thermal conditions of the pregnant ewe are not different after 5 hours from 5 to 7 days after the surgical procedure.

Animals↗

PubMed1988

Pharmacological effects and metabolism of neurotensin and bradykinin in the isolated rat uterus.

Neurotensin (NT) and bradykinin (BK) were found to cause contractions of isolated rat uterus preparations. In 97% of the experiments, acute tachyphylaxis followed soon after the initial administration of NT. Interrelation between the oxytocic effects of NT and BK was not observed. Among the NT fragments studied, only NT-(9-13) had an oxytocic effect (less than 1.0%). All NT fragments tested induced tachyphylaxis to NT regardless of their efficacy. Using HPLC analysis, NT but not BK was found to be degraded by the intact rat uterus. A major involvement of a carboxydipeptidase cleaving at Tyr11-Ile12 is suggested. Carboxyl-blocked neurotensinamide (NT-NH2) was found to be resistent to proteolysis and not develop tachyphylaxis. No cross-tachyphylaxis was observed with NT or NT-(1-11). The results suggest the existence of different receptors for NT and BK in the uterus, as well as the existence of different receptors or receptor states that interact with NT or NT-NH2 in the rat uterus.

Animals↗

PubMed1992

Influence of hormonal treatment on the response of the rat isolated uterus to histamine and histamine receptor agonists.

The response of the isolated uterus to histamine and histamine agonists was investigated in progesterone- and oestrogen-treated rats. The uterine inhibitory responses to histamine and 4-methylhistamine (a histamine H2 receptor agonist) were similar in KCl-contracted uteri from progesterone- and oestrogen-treated rats. The histamine H1 receptor agonist, 2-pyridyl-ethylamine, produced a relaxant response only in progesterone dominant uterus. This was inhibited by the histamine H1 receptor antagonist. In the rat isolated uterus which was not preconstricted by KCl, neither histamine, 4-methylhistamine, nor 2-pyridyl-ethylamine produced any effect in the presence or absence of ranitidine. Ranitidine competitively antagonized the histamine-relaxant uterine response in oestrogen-treated rats (pA2 = 7.21 (6.83-7.58)), but not in progesterone-treated rats, except in the presence of clemizole (10(-7) M) when the pA2 value of ranitidine against histamine was similar to that obtained in oestrogen-treated rats (pA2 = 6.74 (6.64-6.85)). These results indicate that treatment with ovarian steroids influences responses mediated by the histamine receptors of the isolated rat uterus. Both histamine H2 and H1 receptors contribute to the uterine inhibitory effect of histamine in progesterone-treated rats.

Animals↗

PubMed1989

The expression of genes coding for positive acute-phase proteins in the reproductive tract of the female rat. High levels of ceruloplasmin mRNA in the uterus.

High levels of ceruloplasmin mRNA were measured in the uterus of both pregnant and non-pregnant rats. No mRNA for alpha 2-macroglobulin and alpha 1-acid glycoprotein could be detected in the uterus in contrast to the high levels of those two mRNAs found in the decidua in the mid-gestation period. Synthesis of plasma proteins with a protective function in the decidua or uterus may be important in maintaining homeostasis at different stages of reproduction. In addition, ceruloplasmin synthesis by the uterus may be part of a system transporting copper to the fetus.

Acute-Phase Proteins↗

PubMed1992

Effects of estradiol valerate on the uterus of the musk shrew (Suncus murinus L.).

The effects of exogenous estradiol valerate on some uterine characteristics of the musk shrew were investigated. Treatment with the steroid for either 1 day or 7 days did not noticeably alter luminal epithelial cell height, endometrial gland epithelial cell height or diameter, or number of endometrial glands. The reciprocal values of cell density of circular muscle and deep endometrial layers and endometrium-to-myometrium ratio of the uterus increased significantly in response to 7 days of steroid administration. After 1 day of steroid treatment the numbers of mast cells in different layers of the uterus (i.e., meso-, myo-, and endometrium) were unchanged, but after 7 days there were significant increases in the number of mast cells in meso- and myometria. The number of eosinophils in all three layers of the uterus increased significantly in response to the treatment of estradiol for 1 day or for 7 days. The increase was greater in the 7-day group. Neither uterine DNA nor RNA contents changed following administration of the steroid for either group, although protein content was elevated significantly in the 7-day group. Estradiol administration thus evokes small but subtle changes in the uterus of the musk shrew.

Animals↗

PubMed1983

Epithelial cell involvement in the estradiol-stimulated accumulation of IgA in the rat uterus.

Immunoglobulin A (IgA) and G (IgG) were analyzed in rat plasma, uterus and uterine secretions by radioimmunoassay and in tissues by immunofluorescent microscopy to determine the mechanism by which estradiol controls IgA and IgG movement from the uterus into the uterine lumen. To determine whether there was evidence for immunoglobulin transport, plasma, tissue and uterine fluid concentrations of IgA and IgG were measured in ovariectomized rats at a time when uterine fluid IgA and IgG were elevated by treatment with estradiol. The concentration of IgA in uterine fluid was 22 times greater than that in tissue indicating that, in response to estradiol, IgA accumulated in the lumen against an apparent concentration gradient. In contrast to IgA, the concentration of IgG in uterine fluid was significantly lower than that in the uterus and in plasma. Immunofluorescent analyses indicated that estradiol has a marked effect on IgA associated with uterine epithelial cells. In saline-injected controls, small amounts of IgA were found in the epithelial cells and in the basement region of these cells. In response to estradiol, IgA accumulated in these cells at a time that coincided with the known increase of IgA in the uterine lumen. No IgA increase was observed when progesterone was given along with estradiol. Similar analyses for IgG, failed to demonstrate epithelial cell involvement of IgG into the uterine lumen. These experiments indicate that in response to estradiol, IgA is moved into the uterine lumen by a mechanism that is distinctly different from that which controls IgG. Since IgA movement is against an apparent concentration gradient, it suggests that estradiol acts on epithelial cells to regulate IgA transport from the uterus into the uterine lumen.

Animals↗

PubMed1986

A method for the determination of estrogen receptor concentration in calf uterus and other tissues using an aqueous two-phase system.

An assay for the cytoplasmic estrogen receptor in calf, human and rat uterus has been developed. The method is based on partial separation of free and bound estradiol (E2) by means of an aqueous two-phase system containing dextran and poly(ethylene glycol), respectively, in the two phases. Low-speed supernatant from uterus homogenate is equilibrated with E2 and [3H]E2. A two-phase mixture is then added and bound E2 will partition into the lower phase while free E2 is distributed in both phases according to its partition coefficient. The amounts of bound and free E2 are calculated and the receptor concentration and association constant are obtained from a Scatchard plot. No dissociation of bound E2 in the phase system could be demonstrated at 4 degrees C. The interassay coefficient of variation for receptor concentration at 4 degrees C was 20 and 14% for calf and human uterus, respectively. The intraassay variation for receptor concentration in calf uterus determined at 4 degrees C and 23 degrees C was 7.1 and 4.1%, respectively. The influence of freezing the tissue and supernatant preparation was examined and results from supernatant preparations obtained with different centrifugations were compared. The method is simple and rapid, permitting large numbers of samples to be handled efficiently by a single technician.

Animals↗

PubMed1987

Phosphorylation on tyrosine of oestradiol-17 beta receptor in uterus and interaction of oestradiol-17 beta and glucocorticoid receptors with antiphosphotyrosine antibodies.

In whole rat uterus incubated in the presence of [32P]orthophosphate the oestradiol receptor is [32P]phosphorylated on tyrosine. This finding follows our previous observation that in vitro this receptor can be phosphorylated on tyrosine by a uterus kinase that endows the receptor with oestradiol-binding activity. The calf uterus oestradiol receptor interacts with high affinity with 2G8 and 1G2 antiphosphotyrosine antibodies coupled to Sepharose (Kd values of 0.28 and 1.1 nM, respectively). The interaction with 2G8 antibody has been exploited to purify the oestradiol receptor. This interaction disappears after inactivation of the oestradiol receptor by the nuclear phosphatase that hydrolyses phosphotyrosine of the receptor. This fact substantiates the evidence that the oestradiol receptor in uterus is phosphorylated on tyrosine and that this phosphorylation is required for hormone binding to the receptor. The rat liver glucocorticoid receptor also interacts with high affinity with 2G8 antiphosphotyrosine antibody coupled to Sepharose (Kd value of 0.21 nM). This receptor has been purified by using in sequence heparin-Sepharose and antiphosphotyrosine antibody-Sepharose.

Animals↗

PubMed1989

Concentration and turnover of estradiol in the rat uterus in vivo.

The concentrations and turnover of estradiol isolated from cytosolic and nuclear fractions of uteri from ovariectomized rats given estradiol, either in single injections or in continuous infusion, were analyzed by gas chromatography-mass spectrometry. The analytical method was validated for different organs and lower limits of analysis were established. After infusion of 20 ng x h-1 for 18-22 h, mean estradiol levels were 2.0-2.4 fmol x mg-1 uterine wet weight in the nuclear fraction, and 1.2-1.5 fmol x mg-1 in the cytosolic fraction. The concentrations were about five times higher after a single injection of one microgram estradiol but the distribution between nuclear and cytosolic fractions was almost the same. The concentrations of estradiol in nuclei from liver and spleen were 50-200 times lower than those in uterus. Taken together with previous knowledge, the results indicate that the distributions of estradiol and its receptor are not the same and that hormone response cannot be predicted from the concentration of receptors alone. The exchange of estradiol molecules in the uterus was followed after a change of the infusion from unlabelled to [11,12,12-2H3]-labelled estradiol, or vice versa. The uterine uptake of estradiol was calculated to be about 0.7 fmol x h-1 x mg-1 uterine wet weight. The half-life time was calculated to be at least 4 h for estradiol molecules isolated from the nuclear fraction and 3 h (significantly shorter) for those isolated from the cytosolic fraction. The results indicate an uptake of 40-90% of all estradiol passing through the uterus in proestrus with only about 10% of available receptors becoming occupied. When the infusion was changed from estradiol to ethynylestradiol, estradiol disappeared from the uterus at the same rate as in the experiments above. Ethynylestradiol was taken up at a rate of about 0.3-0.4 fmol x h-1 x mg-1 tissue. The percentage of total steroid found in the nuclear fraction was higher for ethynylestradiol, about 70%, than for estradiol, about 60%, indicative of a more stable association of receptor to nuclear binding sites when ethynylestradiol is the ligand.

Animals↗

PubMed1985

Characterization of angiotensin II binding sites in African Green monkey uterus.

The observation that there are significant differences in the concentration, affinity, and specificity of both central nervous system (CNS) and peripheral angiotensin receptors among several different mammalian species, including the African Green monkey, led to the detailed analysis of 125I-angiotensin II binding in the uterus of the African Green monkey. The Bmax for angiotensin receptors in uterine tissue from this species is 56.6 +/- 8.7 fmole per mg protein. The Kd for angiotensin II is .601 +/- .108 nM. The specificity of the receptor is similar to that reported for the uterus of the rat and dog. These results indicate that the angiotensin II receptors, although nearly absent from the CNS of the African Green monkey, are found in the uterus and are very similar to uterine receptors previously characterized in the rat and dog and support the use of these species as appropriate models for studying the biochemistry of angiotensin binding in the uterus.

Angiotensin II↗

PubMed1995

Corticotropin-releasing hormone (CRH) is expressed at the implantation sites of early pregnant rat uterus.

We have shown previously that the epithelial cells of human endometrium produce CRH. The biological role of endometrial CRH is not yet known. Among other things, CRH appears to be involved in the inflammatory process, acting as an autocrine/paracrine proinflammatory regulator. Since the reaction of endometrium to the invading blastocyst has characteristics of an aseptic inflammatory reaction, we have hypothesized that endometrial CRH may participate in the inflammatory phenomena taking place at the implantation site of blastocyst. In the present study we demonstrate a higher content of immunoreactive (IR)-CRH and CRH mRNA in the implantation sites of early pregnant rat uterus compared to the inter-implantation regions. Specifically we have found that: a) rat uterus contained a 1.3 kb CRH transcript, similar or identical in size to that present in human placenta, b) the size of the IR-CRH present in uterine extracts was similar to authentic hypothalamic CRH, c) Northern blot analysis showed that the content of CRH mRNA in uterus at the implantation sites was 3.5 fold higher compared to that in the inter-implantation regions and finally, d) immunohistochemical localization of IR-CRH in early pregnant rat uterus revealed positive staining of the luminal epithelial cells in both implantation and inter-implantation uterine regions, while decidualized stromal cells were positive only at the implantation sites. Our data suggest that endometrial CRH may play a role in the implantation of blastocyst.

Animals↗

PubMed1996

Changes in citrate concentration in the mouse uterus with experimentally-induced adenomyosis.

Components of the uterine fluid in mice with experimentally-induced adenomyosis and in controls were examined by proton nuclear magnetic resonance spectroscopy. One of the components was markedly different in mice with adenomyosis. As this component was estimated to be citrate by comparison with authentic samples (standard spectrum), its levels in uterine fluid, uterine tissue and blood were determined by enzymatic analysis. The fluid obtained from the uterus with adenomyosis showed significantly lower concentration of citrate than that from normal uterus. However, the uterine tissue concentration was significantly higher in the experimental mice with adenomyosis. There was no difference in the blood citrate level between the experimental and the control groups. Since adenomyosis was induced by chronic hyperprolactinemia, the change of citrate level in the uterus with this lesion might imply some effects of prolactin (PRL) on metabolism and/or secretion of citrate. However, in normal mice, no significant change was demonstrated in uterine citrate concentration after short-term experimental modulation of the circulating PRL level. Thus, it is unlikely that PRL can regulate directly citrate metabolism in the uterus, indicating some other cause for changes in citrate level accompanying the development of adenomyosis.

Animals↗

PubMed1993

Balance of amino acids in the pregnant human uterus at term.

The nutritive and metabolic state of the human uterus at term is evaluated by measuring the uptake and release of amino acids. The subjects are ten healthy women with normal pregnancy undergoing elective caesarean section at term, before onset of labour. Free amino acids in arterial (radial artery) and venous (plexus of the uterine and ovarian veins) blood are determined and arteriovenous (AV) differences in each amino acid across the uterus are calculated. Generally the AV differences are negative, i.e. uterus at term releases amino acids in most cases. The human pregnant uterus at term is characterized by a release of amino acids rather than uptake. This indicates that they are in excess and are not needed in anabolic processes or as a fuel, even when the uterine tissue at term is supposed to be preparing for its grand performance, i.e. the delivery.

Adult↗