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Lecture notes

Parturition

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University of Edinburgh lecture notes for Reproductive Biology 3 lecture "Parturition"

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  • April 28, 2023
  • 7
  • 2020/2021
  • Lecture notes
  • Simon riley
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alexgpegg
Parturition
 Preterm labour and complications
o Complications occur in 6-10% of deliveries in the developed world
 Little change in rate in the last 30 years
o Very low birthweight infants (<1500g) have major problems
o Preterm babies have 85% survival rate due to improved neonatal care
 25% have motor impairment
 30% have hearing and visual impairment
 40-60% have special educational needs
o Preterm birth increases chance of long-term chronic lung and heart disease
and diabetes
 They also have increased admission to hospital for acute illness
o We need to understand regulation of labour due to the severity of preterm
birth
 Foetuses are programmed for later life in utero
 Safe motherhood
o Half a million maternal deaths per annum
o 300 million mothers have short- and long-term morbidity
o Higher chance of death in developing and poorest parts of the world due to:
 Limited health care, particularly in rural areas
 Lack of trained birth attendants
o Lifetime risk of maternal death:
 Developed world- 1/2500
 Developing world- 1/60
 Poorest areas- 1/16
 War zones- 1/7
o These figures show that everyone who is having a baby is at risk of death, but
that there is a higher chance in poorer areas
o Very basic training and drugs make a huge difference
 Regulation of labour in sheep
o There are hormonal changes in sheep that trigger the initiation of labour
 Firstly, foetal cortisol begins to increase 8 days before delivery
 There is a separation between foetal and maternal blood that
stops maternal cortisol passing into the foetus
o 11βHSD breaks down cortisol so it doesn’t enter the foetus
 Foetal cortisol levels can be a representation of foetal brain
development
 Secondly, there is a drop in maternal progesterone about 5 days before
delivery
 Progesterone is essential for maintenance of pregnancy

,  It is secreted firstly by the corpus luteum, then by the placenta
 Progesterone is involved in immune suppression
o Also maintains uterine quiescence and suppresses
myometrial activity
 Progesterone receptor agonist (RU486)- an antigesterone
o RU486 binds to progesterone receptors
o Prevents progesterone signalling and induces labour





o The foetal anterior pituitary is stimulated to secrete ACTH
 There is an increase in ACTH levels before labour occurs
 A non-functional HPA axis can lead to brain defects such as creating a
one-eyed lamb





 Without the HPA axis driving an increase in ACTH, labour does not occur
 Occurs because ACTH is not present to increase cortisol levels
 Lambs on the left were delivered at 230 days (about 80 days late)
 Lambs on the right were normal





o Trophoblast steroidogenesis

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