Anatomical and physiological aspects of the mutual influence of circulatory hypoxia of the myometrium and non-progressive labour

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Abstract

Non-progressive labour occurs in almost 10% of deliveries and is a main reason for unplanned cesarean sections and operative vaginal births using obstetric forceps or vacuum extraction. This article describes the morphological transformation of the myometrium and uterine blood vessels that occurs during pregnancy. It is shown that the myometrium inevitably experiences hypoxia at the microstructural level during each normal or pathological labour. We analyzed recent studies of the mutual influence of myometrial hypoxia and labour dystocia. Experimental and clinical studies showed relationship between the pH values and lactate levels determined in the myometrium on its contractility. Further research is justified, including the study of the pH and lactate values in amniotic fluid in patients with non-progressive labor. Finally, that will allow for clarifying the conditions and timing of labour stimulation with oxytocin and identifying a group of patients for whom oxytocin administration is contraindicated or hopeless.

About the authors

Dmitry S. Sudakov

North-Western State Medical University named after I.I. Mechnikov; The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Author for correspondence.
Email: suddakovv@yandex.ru
ORCID iD: 0000-0002-5270-0397
SPIN-code: 6189-8705

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg; Saint Petersburg

Igor P. Nikolaenkov

Leningrad Regional Perinatal Center

Email: nikolaenkov_igor@mail.ru
ORCID iD: 0000-0003-2780-0887
SPIN-code: 5571-4620

MD, Cand. Sci. (Medicine)

Russian Federation, Gatchina

Yulia R. Dymarskaya

North-Western State Medical University named after I.I. Mechnikov

Email: julia_dym@mail.ru
ORCID iD: 0000-0001-6027-6875
SPIN-code: 4195-3410

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Anna A. Kuznetsova

North-Western State Medical University named after I.I. Mechnikov

Email: anika8820@mail.ru
ORCID iD: 0000-0002-6901-9004
SPIN-code: 9077-0209
Russian Federation, Saint Petersburg

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2. Fig. 1. Photo portrait of Doctor of Medical Science, Professor Emeritus of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School Emanuel A. Friedman

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3. Fig. 2. Photo portrait Doctor of Medical Science, Professor, Head of the Department of Obstetrics and Gynecology of the First Leningrad Medical Institute Ilya I. Yakovlev

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4. Fig. 3. Publication activity indicators on the problem of abnormal labour (according to the PubMed search engine)

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5. Fig. 4. Microanatomy of the myometrium [16]

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6. Fig. 5. Myometrium of the uterine fundus in full-term pregnancy [19]. A sample of the normal myometrium taken between leiomyoma nodes. Masson’s trichrome staining, zoom ×10. After fixation, the thickness of the myometrium from the serous membrane to the inner surface in this section was 22 mm

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Согласие на обработку персональных данных с помощью сервиса «Яндекс.Метрика»

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2. Категории обрабатываемых данных: файлы «cookies» (куки-файлы). Файлы «cookie» – это небольшой текстовый файл, который веб-сервер может хранить в браузере Пользователя. Данные файлы веб-сервер загружает на устройство Пользователя при посещении им Сайта. При каждом следующем посещении Пользователем Сайта «cookie» файлы отправляются на Сайт Оператора. Данные файлы позволяют Сайту распознавать устройство Пользователя. Содержимое такого файла может как относиться, так и не относиться к персональным данным, в зависимости от того, содержит ли такой файл персональные данные или содержит обезличенные технические данные.

3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».