Oxytocin augmentation and neurotransmitters in prolonged delivery: An experimental appraisal

• Published in: European journal of obstetrics & gynecology and reproductive biology: X Vol. 21; p. 100273
• Main Authors: Malvasi, Antonio, Ballini, Andrea, Tinelli, Andrea, Fioretti, Bernard, Vimercati, Antonella, Gliozheni, Elko, Baldini, Giorgio Maria, Cascardi, Eliano, Dellino, Miriam, Bonetti, Monica, Cicinelli, Ettore, Vitagliano, Amerigo, Damiani, Gianluca Raffaello
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2024; Elsevier
• Subjects: Asynclitism; Dystocia; Intrapartum ultrasound; Lower uterine segment; Neurofibers; Neurotransmitters; Obstetrics and Maternal Fetal Medicine; Occiput posterior position; Oxytocin; Prolonged labor; Intrapartum ultrasound; Neurotransmitters; Asynclitism; Oxytocin; Dystocia; Occiput posterior position; Lower uterine segment; Neurofibers; Prolonged labor
• ISSN: 2590-1613; 2590-1613
• DOI: 10.1016/j.eurox.2023.100273

The uterus is a highly innervated organ, and during labor, this innervation is at its highest level. Oxytocinergic fibers play an important role in labor and delivery and, in particular, the Lower Uterine Segment, cervix, and fundus are all controlled by motor neurofibers. Oxytocin is a neurohormone that acts on receptors located on the membrane of the smooth cells of the myometrium. During the stages of labor and delivery, its binding causes myofibers to contract, which enables the fundus of the uterus to act as a mediator. The aim of this study was to investigate the presence of oxytocinergic fibers in prolonged and non-prolonged dystocic delivery in a cohort of 90 patients, evaluated during the first and second stages of labor. Myometrial tissue samples were collected and evaluated by electron microscopy, in order to quantify differences in neurofibers concentrations between the investigated and control cohorts of patients. The authors of this experiment showed that the concentration of oxytocinergic fibers differs between non-prolonged and prolonged dystocic delivery. In particular, in prolonged dystocic delivery, compared to non-prolonged dystocic delivery, there is a lower amount of oxytocin fiber. The increase in oxytocin appeared to be ineffective in patients who experienced prolonged dystocic delivery, since the dystocic labor ended as a result of the altered presence of oxytocinergic fibers detected in this group of patients.