Regulation of parturition update. Endocrine and paracrine effectors of term and preterm labor.

This article summarizes the role of endocrine and paracrine mediators of human parturition. Gonadal steroids (17 beta--estradiol and progesterone) mediate many of the decidual and uterine contractile functions during early events in labor. Proinflammatory cytokines and chemokines orchestrate many of the events triggering or sustaining active labor at term and in the preterm setting. Several autacoids (prostaglandins, platelet-activating factor) serve proximal activities such as uterine contractility and remodeling of the cervical extracellular matrix leading to dilatation and effacement. As the biochemical participants during parturition become more clearly understood, it will be possible to develop improved surveillance, management, and treatment strategies for preterm labor.