Am J Perinatol 2021; 38(02): 126-130
DOI: 10.1055/s-0039-1694980
Original Article

Spontaneous Human Myometrial Contractility in the Third Trimester of Pregnancy in Relation to Past Mode of Delivery

1   Department of Obstetrics and Gynecology, Galway University Hospital, National University of Ireland Galway, Galway, Ireland
2   Department of Obstetrics and Gynecology, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland
,
Sarah M. Nicholson
1   Department of Obstetrics and Gynecology, Galway University Hospital, National University of Ireland Galway, Galway, Ireland
,
Denis J. Crankshaw
1   Department of Obstetrics and Gynecology, Galway University Hospital, National University of Ireland Galway, Galway, Ireland
2   Department of Obstetrics and Gynecology, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland
,
John J. Morrison
1   Department of Obstetrics and Gynecology, Galway University Hospital, National University of Ireland Galway, Galway, Ireland
2   Department of Obstetrics and Gynecology, Lambe Institute for Translational Research, National University of Ireland Galway, Galway, Ireland
› Author Affiliations
Funding This study was funded by the National University of Ireland Galway Perinatal Fund.

Abstract

Objective It is well established that women with a previous vaginal delivery have higher success rates in relation to vaginal birth after cesarean than those without. The aim of this study was to examine the effect of past mode of delivery on contractile parameters of human myometrium in vitro.

Study Design Myometrial strips were excised from 64 women at cesarean delivery (CD) and recordings of spontaneous contractile activity analyzed and compared across three clinical groups: (1) women with no previous delivery (Group 1); (2) women with CD only (Group 2); and (3) women with a history of vaginal delivery and CD (Group 3).

Results Myometrial samples from women in Group 3, women who had a previous vaginal delivery, had a significantly greater maximum amplitude of contractions (p < 0.05), a greater force (mean contractile force) of contractions (p < 0.01), and a faster rate of rise (p < 0.01) and relaxation of contractions (p < 0.05) than those in Groups 1 and 2.

Conclusion Many of the functional parameters of human uterine contractions are altered, or enhanced, in the women who have had a previous vaginal delivery, when compared with those without. This may partly explain the clinical differences observed in labor.



Publication History

Received: 28 February 2019

Accepted: 04 July 2019

Article published online:
20 August 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Ryan GA, Nicholson SM, Morrison JJ. Vaginal birth after caesarean section: Current status and where to from here?. Eur J Obstet Gynecol Reprod Biol 2018; 224: 52-57
  • 2 RCOG Green-top Guideline No. 45. Birth After Caesarean Section, October 2015. Accessed July 29, 2019 at: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf
  • 3 Centers for Disease Control and Prevention; Births Final Data 2015. Accessed July 29, 2019 at: https://www.cdc.gov/nchs/nvss/births.htm
  • 4 EURO-PERISTAT. European perinatal health report: the health and care of pregnant women and babies in Europe in 2010. Accessed July 29, 2019 at: http://www.europeristat.com/reports/european-perinatal-health-report-2010.html
  • 5 National Institutes of Health Consensus Development Conference Panel. National Institutes of Health Consensus Development conference statement: vaginal birth after cesarean: new insights March 8-10, 2010. Obstet Gynecol 2010; 115 (06) 1279-1295
  • 6 Brick A, Layte R, Farren M, Mahony R, Turner MJ. Recent trends in vaginal birth after caesarean section. Ir Med J 2016; 109 (10) 482
  • 7 Knight HE, Gurol-Urganci I, van der Meulen JH. et al. Vaginal birth after caesarean section: a cohort study investigating factors associated with its uptake and success. BJOG 2014; 121 (02) 183-192
  • 8 Uddin SF, Simon AE. Rates and success rates of trial of labor after cesarean delivery in the United States, 1990-2009. Matern Child Health J 2013; 17 (07) 1309-1314
  • 9 Cheng YW, Eden KB, Marshall N, Pereira L, Caughey AB, Guise JM. Delivery after prior cesarean: maternal morbidity and mortality. Clin Perinatol 2011; 38 (02) 297-309
  • 10 Eden KB, McDonagh M, Denman MA. et al. New insights on vaginal birth after cesarean: can it be predicted?. Obstet Gynecol 2010; 116 (04) 967-981
  • 11 Ryan GA, Nicholson SM, Crankshaw DJ, Morrison JJ. Maternal parity and functional contractility of human myometrium in vitro in the third trimester of pregnancy. J Perinatol 2019; 39 (03) 439-444
  • 12 Crankshaw DJ, O'Brien YM, Crosby DA, Morrison JJ. Maternal body mass index and spontaneous contractility of human myometrium in pregnancy. J Perinatol 2017; 37 (05) 492-497
  • 13 Crankshaw DJ, O'Brien YM, Crosby DA, Morrison JJ. Maternal age and contractility of human myometrium in pregnancy. Reprod Sci 2015; 22 (10) 1229-1235
  • 14 O'Sullivan MD, Hehir MP, O'Brien YM, Morrison JJ. 17 alpha-hydroxyprogesterone caproate vehicle, castor oil, enhances the contractile effect of oxytocin in human myometrium in pregnancy. Am J Obstet Gynecol 2010; 202 (05) 453.e1-453.e4
  • 15 Moynihan AT, Hehir MP, Sharkey AM, Robson SC, Europe-Finner GN, Morrison JJ. Histone deacetylase inhibitors and a functional potent inhibitory effect on human uterine contractility. Am J Obstet Gynecol 2008; 199 (02) 167.e1-167.e7
  • 16 Crankshaw DJ, Walsh JM, Morrison JJ. The effects of methyl palmitate, a putative regulator from perivascular fat, on the contractility of pregnant human myometrium. Life Sci 2014; 116 (01) 25-30
  • 17 Crankshaw DJ, Morrison JJ. Methodology and pharmacological analysis of effects of uterotonic compounds in human myometrium in vitro. Am J Obstet Gynecol 2011; 205 (02) 155.e1-155.e6
  • 18 Cohen WR, Friedman EA. The assessment of labor: a brief history. J Perinat Med 2018; 46 (01) 1-8