Malvasi Antonio, Ballini Andrea, Tinelli Andrea, Fioretti Bernard, Vimercati Antonella, Gliozheni Elko, Baldini Giorgio Maria, Cascardi Eliano, Dellino Miriam, Bonetti Monica, Cicinelli Ettore, Vitagliano Amerigo, Damiani Gianluca Raffaello
Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy.
Unit of Obstetrics and Gynecology, University of Bari, Bari, Italy.
Eur J Obstet Gynecol Reprod Biol X. 2023 Dec 23;21:100273. doi: 10.1016/j.eurox.2023.100273. eCollection 2024 Mar.
The uterus is a highly innervated organ, and during labor, this innervation is at its highest level. Oxytocinergic fibers play an important role in labor and delivery and, in particular, the Lower Uterine Segment, cervix, and fundus are all controlled by motor neurofibers. Oxytocin is a neurohormone that acts on receptors located on the membrane of the smooth cells of the myometrium. During the stages of labor and delivery, its binding causes myofibers to contract, which enables the fundus of the uterus to act as a mediator. The aim of this study was to investigate the presence of oxytocinergic fibers in prolonged and non-prolonged dystocic delivery in a cohort of 90 patients, evaluated during the first and second stages of labor. Myometrial tissue samples were collected and evaluated by electron microscopy, in order to quantify differences in neurofibers concentrations between the investigated and control cohorts of patients. The authors of this experiment showed that the concentration of oxytocinergic fibers differs between non-prolonged and prolonged dystocic delivery. In particular, in prolonged dystocic delivery, compared to non-prolonged dystocic delivery, there is a lower amount of oxytocin fiber. The increase in oxytocin appeared to be ineffective in patients who experienced prolonged dystocic delivery, since the dystocic labor ended as a result of the altered presence of oxytocinergic fibers detected in this group of patients.
子宫是一个神经高度分布的器官，在分娩过程中，这种神经分布处于最高水平。催产素能纤维在分娩过程中起着重要作用，特别是子宫下段、宫颈和宫底均受运动神经纤维控制。催产素是一种神经激素，作用于子宫肌层平滑肌细胞膜上的受体。在分娩阶段，其结合会导致肌纤维收缩，使子宫底部起到介导作用。本研究的目的是在90例患者队列中，调查产程延长和未延长的难产分娩中催产素能纤维的存在情况，这些患者在分娩第一和第二阶段进行评估。收集子宫肌层组织样本并通过电子显微镜进行评估，以量化研究组和对照组患者神经纤维浓度的差异。该实验的作者表明，催产素能纤维的浓度在产程未延长和延长的难产分娩之间存在差异。特别是，在产程延长的难产分娩中，与产程未延长的难产分娩相比，催产素纤维的数量较少。催产素的增加在产程延长的难产患者中似乎无效，因为这组患者中检测到的催产素能纤维存在改变，导致难产分娩结束。
