Obstetric Labor Complications Clinical Trial
Official title:
Study of the Effect of Eicosanoids on Contractile Activity of Pregnant Human Myometrium in Pathological Situation.
Recent studies show that EET and 20-HETE have important biological effects, particularly in
the vascular system. The investigators studied the effect of eicosanoids on the gravid rat
uterus. The results suggest that 20-HETE had an tocolytics effect on gravid uterus. In the
previous study, we demonstrated that the enzymes of the pathway of EET were present in human
uterine tissues. Moreover, the addition of an inhibitor of degradation of EET had an
tocolytic effect on the human myometrium, as the exogenous addition of 8.9, 14,15-EET and
20-HETE.
Objectives:
Primary objective: To compare the balance of different metabolic pathways of arachidonic
acid (AA) of the pregnant human myometrium in pathological situations (preterm labor,
uterine atony, prolonged pregnancy).
Specific objectives: i) To study the effect of derived from the AA on in vitro contractile
activity of normal and pathological uterine tissues, and ii) detect and quantify the
different sub-products of metabolism of AA in the uterine tissues (myometrium, fetal
membranes and placenta).
The management of uterine contraction is in the heart of modern obstetrics year, yet the
progress made in other specialties, based on the study of smooth muscle have not yet been
transposed in obstetrics. A better understanding of systems for regulating the contraction
is important in terms of 1) new physiological knowledge, but it could also be the source of
2) modification of strategies to take care of premature delivery (new Tocolytic), or 3)
improving the efficiency of uterine muscle during delivery or 4) for treatment of patients
with prolonged pregnancy.
It is a clinical study with a slope fundamental aims to examine the metabolic pathways of AA
of human myometrium and their functional roles according to their clinical profile divided
into three contractile pathological situations - threat of premature delivery, dynamic
dystocia, prolonged pregnancy - and two groups of patients at term: a group before work and
group work.
The sampling method. After birth, a biopsy will be perform from the lower segment of the
uterus. After caesarean sections of membrane and placenta are collected.
The substances studied during isometric tension tests are part of the three degradation
pathways of the AA.
1. new eicosanoids in cumulative dose (8,9-EET, 11,12-EET, 14,15-EET, 20-HETE), and in
combination
2. enzyme inhibitors of the eicosanoids pathway (AUDA, MS-PPOH, DDMS), and the COX and LOX
pathways (indomethacin), alone or in combination.
;
Observational Model: Case-Only, Time Perspective: Prospective
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