PTL

Question 1

What experiments were done to see how stretch affects labour?

Answer 1

Mouse model
Two uterine horns
One made pregnant

Unstretched produced less oestrogen
Tube stretched produced more

Stretch up regulates cytokines and COX proteins.

Question 2

Give some figures for PTL.

Answer 2

In 2005 1:13 live births in England and Wales were pre term.

7.7% per year

1% before 30 weeks –> 80% of mortalities.

Question 3

Historic tocolytics.

Answer 3

Aminophylline (PDE inhibitor)

Ethanol

Question 4

Abandoned

Answer 4

NO (cervical ripening)

Antimicrobials (preventative - but worse outcomes)

Question 5

Future?

Answer 5

Viagra

Retigabine - Kv7 channel agonist
Increase threshold for contractions
Delayed labour by 6 hours in mouse models.

Question 6

What COX-2 inhibitor was given to women and what happened?

Answer 6

Rofecoxib

Earlier delivery.

Question 7

What is done with progesterone?

Answer 7

Medroxyprogesterone acetate - prevents PTL in animals

Antagonist RU486 induces delivery in animals and women.

Question 8

What are the four prophylactic targets?

Answer 8

Maintain cAMP

Prevent progesterone withdrawal

Treat infection

Inhibit inflammation