Journal of the European Society for Gynaecological Endoscopy

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Metabolic Modulation of the Myometrium and Labour, Term and Preterm

Keywords:

adipocytokines, cholesterol, dysfunctional labor, hyperlipidemia, myometrium, obesity, preterm labor

M.P. Hehir, J.J. Morrison

Department of Obstetrics & Gynaecology, National University of Ireland Galway, Ireland.

Correspondence at: john.morrison@nuigalway.ie or http://www.nuigalway.ie/obsgyn/

Abstract

An understanding of the physiological and pharmacological factors regulating myometrial contractility is essential to development of therapeutic interventions aimed at addressing the clinical disorders associated with labor. Preterm labor and dystocia are the clinical conditions associated with dysfunctional myometrial contractility. Both conditions are seen in increased frequency in the presence of maternal obesity. This review serves to address the role of ­adipocytokines, secretory products of adipose tissue, on uterine smooth muscle contractility in pregnancy. These adipocytokines include leptin, ghrelin and apelin. The impact of hypercholesterolemia, hyperlipidemia and other conditions associated with obesity such as diabetes mellitus on myometrial contractile performance is also examined.