uterine motility

Question 1

what is found in the endometrium

Answer 1

glands, blood vessels, lymphatics, epithelial cells

Question 2

what type of gap junction is responsible for uterine contractions

Answer 2

connexin 43

Question 3

what are the functions of uterine smooth muscle gap junctions

Answer 3

hormonally inducible

fundal dominance during labour due to anatomical arrangement

Question 4

what are alpha adrenoreceptors in the uterus responsible for

Answer 4

contraction

Question 5

what are beta adrenoreceptors in the uterus responsible for

Answer 5

relaxation

Question 6

what hormones stimulate uterine contractions

Answer 6

ADH and oxytocin

both 9 aa proteins

Question 7

what factor influences oxytocin

Answer 7

receptor numbers and effect on uterine contractions are influenced by sex hormone levels

Question 8

what hormones are produced by the posterior pituitary gland

Answer 8

oxytocin and ADH

Question 9

what hormones are produced by the anterior pituitary gland

Answer 9

Growth Hormone (GH), Prolactin (PRL), Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Adrenocorticotropic Hormone (ACTH), and Thyroid-Stimulating Hormone TSH).

Question 10

what stimulates oxytocin at the end of pregnancy

Answer 10

falling placental progesterone with sustained oestrogen

stimulates prostaglandin and oxytocin receptors

Question 11

describe uterine contractions during parturition

Answer 11

increasing regular, co-ordinated contractions that travel from the fundus to the cervix
uterus completely relaxes in between

Question 12

what are uterine stimulants used for

oxytocics

Answer 12

abortion
induce and accelerate labour
contract the uterus after delivery to control haemorrhage

Question 13

what are uterine relaxants used for

Answer 13

dysmenorrhoea and menstrual cramps
prevent preterm labour
facilitate obstetric manoeuvers
counteract uterine hyperstimulation

Question 14

what is IV/ IM oxytocin, ergometrine and E and F prostaglandins

Answer 14

oxytocics

Question 15

what is ergometrine used for

Answer 15

obstetric haemorrhage by causing sustained uterine contractions (postpartum haemorrhage, PPH)
however largely obsolete now
(other forms for migraine)

Question 16

what is F series prostaglandin

Answer 16

vasoconstrictor

‘cervical ripening’ and induce oxytocin receptors

Question 17

what is E series prostaglandin

Answer 17

vasodilator

‘cervical ripening’ and induce oxytocin receptors

Question 18

what is dinoprostone, carboprost, gemeprost and misoprostol

Answer 18

prostaglandin analogues

Question 19

describe a medical abortion using prostaglandins

Answer 19

myometrium sensitised by mifepristone which is a progesterone receptor antagonist then misoprostol induces labour

also used to control PPH

Question 20

what is a tocolytic

Answer 20

uterine relaxant

Question 21

what is riodrine, terbutaline and salbutamol

Answer 21

b agonists
increases cAMP levels in smooth muscle
uterine relaxant

Question 22

what are the adverse effects of tocolytics

Answer 22

tachycardia, hypertension and hyperglycaemia

Question 23

what is nifedipine

Answer 23

the current drug of choice for uterine relaxation

calcium channel blocker

Question 24

what are NSAIDS used for

Answer 24

reduce PG synthesis so reduce uterine contractions

eg indomethacin

Question 25

what is indomethacin

Answer 25

NSAID used as a tocolytic

Question 26

what is atosiban

Answer 26

an oxytocin receptor antagonist used as a tocolytic

Question 27

what are nitrates used for

Answer 27

tocolytic

eg nitroglycerine patch

Question 28

what can be used to treat dysmenorrhoea and menorrhagia

Answer 28

prostaglandins

may be due to PGE and PGF imbalance

Question 29

what NSAIDS are useful for dysmenorrhoea

Answer 29

ibruprofen, naproxen and mefanamin acid

may reduce blood loss (also antifibrinolytics)