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Evaluation of synchronization between myoelectric signals can give new insights into the functioning of the complex system of porcine myometrium. We propose a model of uterine contractions according to the hypothesis of action potentials similarity which is possible to detect during propagation in the uterine wall. We introduce similarity measures based on the concept of synchronization as used in matching linear signals such as electromyographic (EMG) time series data. The aim was to present linear measures to assess synchronization between contractions in different topographic regions of the uterus. We use the cross-correlation function (ƒx,y[l], ƒy,z[l]) and the cross-coherence function (Cxy[ƒ], Cyz[ƒ]) to assess synchronization between three data series of a diestral uterine EMG bundles in porcine reproductive tract. Spontaneous uterine activity was recorded using telemetry method directly by three-channel transmitter and three silver bipolar needle electrodes sutured on different topographic regions of the reproductive tract in the sow. The results show the usefulness of the cross-coherence function in that synchronization between uterine horn and corpus uteri for multiple action potentials (bundles) could be observed. The EMG bundles synchronization may be used to investigate the direction and velocity of EMG signals propagation in porcine reproductive tract.

Optic neuritis secondary to systemic lupus erythematosus is a rare manifestation with a prevalence of 1%. The case described concerns a patient who presented with optic neuritis associated with SLE. She was 19 weeks pregnant, and required pulses with methylprednisolone and cyclophosphamide, which are within the category D drugs used during pregnancy. Three weeks later, she presented with uterine activity, and went into labor, with a fetus of 22 weeks gestation and weighing 430 g being obtained, which died 48 h later. In medical practice there are ethical guidelines and economic obstacles to carrying out diagnostic and therapeutic protocols established by limiting clinical practice.

Background Studies which use external tocography to explore the relationship between increased intrapartum uterine activity and foetal outcomes are feasible because the technology is safe and ubiquitous. However, periods of poor signal quality are common. We developed an algorithm which aims to calculate tocograph summary variables based on well-recorded contractions only, ignoring artefact and excluding sections deemed uninterpretable. The aim of this study was to test that algorithm's reliability. Methods Whole recordings from labours at ≥35 weeks of gestation were randomly selected without regard to quality. Contractions and rest intervals were measured by two humans independently, and by the algorithm using two sets of models; one based on a series of pre-defined thresholds, and another trained to imitate one of the human interpreters. The absolute agreement intraclass correlation coefficient (ICC) was calculated using a two-way random effects model. Results The training dataset included data from 106 tocographs. Of the tested algorithms, AdaBoost showed the highest initial cross-validated accuracy and proceeded to optimization. Forty tocographs were included in the validation set. The ICCs for the per tocograph mean contraction rates were; human B to human A: 0.940 (0.890–0.968), human A to initial models: 0.944 (0.898–0.970), human A to trained models 0.962 (0.927–0.980), human B to initial models: 0.930 (0.872–0.962), human B to trained models: 0.948 (0.903–0.972). Conclusions The algorithm described approximates interpretation of external tocography performed by trained humans. The performance of the AdaBoost trained models was marginally superior compared to the initial models.

[EN] Postpartum hemorrhage (PPH) is one of the major causes of maternal mortality and morbidity worldwide, with uterine atony being the most common origin. Currently there are no obstetrical techniques available for monitoring postpartum uterine dynamics, as tocodynamometry is not able to detect weak uterine contractions. In this study, we explored the feasibility of monitoring postpartum uterine activity by non-invasive electrohysterography (EHG), which has been proven to outperform tocodynamometry in detecting uterine contractions during pregnancy. A comparison was made of the temporal, spectral, and non-linear parameters of postpartum EHG characteristics of vaginal deliveries and elective cesareans. In the vaginal delivery group, EHG obtained a significantly higher amplitude and lower kurtosis of the Hilbert envelope, and spectral content was shifted toward higher frequencies than in the cesarean group. In the non-linear parameters, higher values were found for the fractal dimension and lower values for Lempel-Ziv, sample entropy and spectral entropy in vaginal deliveries suggesting that the postpartum EHG signal is extremely non-linear but more regular and predictable than in a cesarean. The results obtained indicate that postpartum EHG recording could be a helpful tool for earlier detection of uterine atony and contribute to better management of prophylactic uterotonic treatment for PPH prevention., This work was supported by the Spanish Ministry of Economy and Competitiveness, the European Regional Development Fund (MCIU/AEI/FEDER, UE RTI2018-094449-A-I00-AR) and the Generalitat Valenciana (GV/2018/104 and AICO/2019/220).

Preterm birth (PTB) is one of the most important complications in pregnancy. Reliable diagnosis means are lacking and the underlying physiological mechanisms are unclear. Determining the location of various correlated and simultaneously active uterus sources from abdominal ElectroHysterogram (EHG) recordings and extracting the corresponding uterus signals is a challenging problem. The use of the EHG for imaging the sources of the uterine electrical activity could be a new and powerful diagnosis technique. In this paper we compare the ability of six distributed source localization methods to recover extended sources of uterus activity from abdominal EHG. As no gold standard to evaluate source localization methods, exists, we perform our evaluation by using a well-controlled realistic simulations of EHG signals, involving several locations. Simulated data were corrupted by physiological EHG noise. The performance of several state-of-the-art techniques for extended source localization is evaluated using a detection accuracy index using the Dipole Localization Error, the Area Under the Receiver Operating Characteristic (ROC) Curve AUC, and the Correlation Coefficient. Keywords: EHG, Uterine activity, Source imaging

[EN] Objective: The objective of this study is to compare the uterine activity response between women administered dinoprostone (prostaglandin E2) and misoprostol (prostaglandin E1) for induction of labour (IOL) by analysing not only the traditional obstetric data but also the parameters extracted from uterine electrohysterogram (EHG). Methods: Two cohorts were defined: misoprostol (25-mg vaginal tablets; 251 women) and dinoprostone cohort (10 mg vaginal inserts; 249 women). All the mothers were induced by a medical indication of a Bishop Score < ¿ 6. Results: The misoprostol cohort was associated with a shorter time to achieve active labour (p ¿ .017) and vaginal delivery (p ¿ .009) and with a higher percentage of vaginal delivery in less than 24 h in mothers with a very unfavourable cervix score (risk ratio (RR): 1.41, IC95% 1.17¿1.69, p ¿ .002). Successful inductions with misoprostol showed EHG parameter values significantly higher than basal state for amplitude and pseudo Montevideo units (PMU) 60¿ after drug administration, while spectral parameters significantly increased after 150¿. This response was not observed in failed inductions. In the successful dinoprostone group, the duration and number of contractions increased significantly after 120¿, PMU did so after 180¿, and no significant differences were found for spectral parameters, possibly due to the slower pharmacokinetics of this drug. Conclusion: Successful inductions of labour by misoprostol are associated with earlier effective contractions than in labours induced by dinoprostone., This work was partially supported by the Spanish Ministry of Economy and Competitiveness and the European Regional Development Fund under grant [DPI2015-68397-R] and by the company Bial SA.

Cardiotocography (CTG) comprises of fetal heart rate (FHR) and uterine activity (UA) monitoring during pregnancy. It is used in hospitals on a regular basis because FHR and UA tracings contain important information about fetal well-being. Despite the CTG’s long history of use (of almost 50 years), the benefits it brings to the daily practice remain unsatisfying. The interpretation of CTG recordings by obstetricians suffer from high inter- and intra-variability, while their computerized analysis still remains difficult. In this paper, we propose both supervised and unsupervised learning by deep Gaussian processes (DGPs) for classification of FHR tracings. In working with real FHR signals, we obtained promising results which demonstrate the potential of the DGPs methodology. Further, we showed that the performance of the DGPs was improved by utilizing corresponding UA signals.

Electronic fetal monitoring (EFM) is used widely during labor & delivery, but existing solutions limit patient mobility, are uncomfortable, and do not consistently capture fetal heart rate (FHR) and uterine activity (UA) signals. A wireless EFM system was developed that features wearable US and tocodynamometer devices that conform to the body and do not require cables or belts. Benchtop testing demonstrated that the devices can accurately and consistently measure simulated FHRs and UAs over clinically meaningful ranges and body curvatures. The wearable EFM devices are expected to provide more reliable signal capture independent of maternal movement and repositioning, while also significantly improving patient comfort and mobility.

This study examined the extent to which prolonged farrowing and parity are associated with plasma oxytocin concentrations and follicular development of oestrous sows during subsequent insemination. A total of 30 sows were allocated to two groups based on farrowing duration: (i) SHORT (n = 14): 159 ± 29 min, (ii) LONG (n = 16): 533 ± 190 min. The sows were also divided into two parity classes: (i) YOUNG (n = 14): parity 2.5 ± 0.8, (ii) OLD (n = 16): parity 6.4 ± 2.3. After weaning, the ovaries were examined daily with transrectal ultrasound. On the second day of oestrus, blood samples were collected for oxytocin (OT) assay at -15, -10, -5, 0, +1, +2, +3, +4, +6, +8, +10, +15, +20, +25, +30, +40, +50 and +60 min with a boar contact between 0 and +10 min. Boar presence stimulated an increase in OT concentrations (p < .05). During boar presence, OT in the LONG group was higher than in the SHORT group (p < .01). The sows in the OLD group had a longer farrowing duration than in the YOUNG group (p < .05). OT levels and diameters of follicles were more relevant for parity than was the duration of farrowing. We therefore conclude that the OT levels and follicular development of oestrous sows are associated due to parity but difficult to be predicted from the duration of previous farrowing.

Purpose: Uterine activity plays a key role in reproduction, and altered patterns of uterine contractility have been associated with important physiopathological conditions, such as subfertility, dysmenorrhea, and endometriosis. However, there is currently no method to objectively quantify uterine contractility outside pregnancy without interfering with the spontaneous contraction pattern. Transabdominal electrohysterography has great potential as a clinical tool to characterize noninvasively uterine activity, but results of this technique in nonpregnant women are poorly documented. The purpose of this study is to investigate the feasibility of transabdominal electrohysterography in nonpregnant women. Methods: Longitudinal measurements were performed on 22 healthy women in 4 representative phases of the menstrual cycle. Twelve electrohysterogram-based indicators previously validated in pregnancy have been estimated and compared in the 4 phases of the cycle. Using the Tukey honest significance test, significant differences were defined for P values below.05. Results: Half of the selected electrohysterogram-based indicators showed significant differences between menses and at least 1 of the other 3 phases, that is the luteal phase. Conclusion: Our results suggest transabdominal electrohysterography to be feasible for analysis of uterine activity in nonpregnant women. Due to the lack of a golden standard, this feasibility study is indirectly validated based on physiological observations. However, these promising results motivate further research aiming at evaluating electrohysterography as a method to improve understanding and management of dysfunctions (possibly) related to altered uterine contractility, such as infertility, endometriosis, and dysmenorrhea.

This work describes a framework that was developed to export and analyze maternal heartrate and uterine activity from a Monica AN24 ECG recording device. 9478 Traces from 5356 patients were processed, the mean recording length was 47 minutes. The framework implemented additional signal cleaning algorithms and extracted accelerations, decelerations, baseline traces, commonly used heartrate variability parameters, phase rectified signal average wavelets and identified beats that were missed by the Monica detection algorithm.

This study evaluates the ability of distributed source localization methods to accurately estimate the location of the sources as well as their sensitivity to the spatial extent of the sources when using EHG data. We use here realistic simulations of uterine electrical activity based on a realistically uterus shape and take into account 16 electrodes for simulated recorde EHG signal, A Data Driven Parcellization (DDP) method was used to segment the uterus surface into non-overlapping regions. Our results showed that the localization is sensitive to the spatial extents of the sources (range from 11 cm2 to 29 cm2, and also to the number and size of the regions defining the model. Our analysis of the evolution of the real sources during contraction showed a non linear propagation of uterine electrical activity.

This study is aimed at evaluation of the capability to indicate the preterm labour risk by analysing the features extracted from the signals of electrical uterine activity. Free access database was used with 300 signals acquired in two groups of pregnant women who delivered at term (262 cases) and preterm (38 cases). Signal features comprised classical time domain description, spectral parameters and nonlinear measures of contractile activity. Their mean values were calculated for all the contraction episodes detected in each record and their statistical significance for recognition of two groups of recordings was provided. Obtained results were related to the previous study where the same features were applied but they were determined for entire signals. Influence of electrodes location, band-pass filter settings and gestation week was investigated. The obtained results showed that a spectral parameter – the median frequency was the most promising indicator of the preterm labour risk.

Monitoring of uterine contractile activity enables to control the progress of labor. Automated detection of contractions is an integral part of the signal analysis implemented in computer-aided fetal surveillance system. Comparison of four algorithms for automated detection of uterine contractions in the signal of uterine mechanical activity is presented. Three algorithms are based generally on analysis of the frequency distribution of signal values. The fourth method relies on analyzing the rate of changes of the uterine activity signal. The reference data in form of beginning and end of contraction episodes were provided by human experts. Obtained results show that all algorithms were capable to detect above 91% reference contractions, and less than 7% of recognized patterns were false. Two algorithms can be distinguished as providing a higher performance expressed by the sensitivity of 95% and the positive predictive value of 97%. Such results could be obtained by optimization of contraction validation criteria.

Background: Good obstetrician must always be alert to detect any sign and symptoms of abnormal labor. Prolongation of labor presents a picture of mental anguish, physical morbidity and may lead to surgical intervention. The goal of this study is to use partograph to monitor labor, initiate uterine activity that is sufficient to produce cervical change and fetal descent while avoiding uterine hyperstimulation, hypostimulation and fetal distress and provide timely surgical intervention where required. Methods: Total of 100 primigravidae, who were booked with us till term were selected for the study and partograph recordings were commenced at 4 cm dilatation. Close foetal and maternal monitoring was done throughout the labour and Partogram was plotted to detect any deviation from normal course. Results: Based on the Partogram findings the patients were grouped into “before alert line” and “between alert and action line” the mode of delivery in these patients was studied. Of the 42% of women who came into this group, 52.3% underwent cesarean delivery, 42.5% had instrumental deliveries and the remaining had vaginal deliveries. Conclusions: This study shows that using the Partogram improves the quality of delivery care, since it permits to identify dystocia and make logical and effective interventions. It reduces unnecessary strain on mothers by reducing total duration of labour, without any increased foetal morbidity and mortality. If accepted as routine procedure, it will be suitable in all situations where the labour room remains busy and congested day and night for better and more efficient management of labour.

We perform the literature review of safety and risks when using uterotonic agents during labor. We consider the conditions for fetus existence during perinatal period, the pathogenesis of fetal hypoxia, including cases of uterotonic agents using. We pay particular attention to approaches for uterine activity monitoring during intrapartum period. We also consider various methods of fetus diagnosis during labor and methods of the newborns state diagnosing in the article.

In this experiment on 38 isolated strips of myometrium (under the experimental conditions in vitro) we have demonstrated the possibility to assess the nature of myometrium contractions as a model of labor. We have recorded contractions caused by pre-stretching bands as well as contractions induced by oxytocin. We have identified the changes in the rhythm and amplitude of contractions in the background of opiates and calcium channel blockers, and demonstrated synergistic effect of opiates acts of on the contractile activity of the myometrium strips through calcium channels.

Tocodynamometry is the most common method of labor evaluation but most clinicians would agree it has limited utility before 26 weeks of gestation. The obesity epidemic has further reduced our ability to accurately detect uterine contractions using the tocodynamometer at any gestational age. We sought to design and test a novel contraction monitor that bypasses the maternal abdomen.An optimized version of an intravaginal electrohysterographic ring device was tested in an ovine model. The device and its methodology as well as the tocodynamometer were validated against the current gold standard uterine activity monitor, the intrauterine pressure catheter in six sheep at varying gestational ages.Both the intravaginal ring device and the tocodynamometer correlated well with IUPC, r = 0.69 and 0.73, respectively (p 0.001). The number of contractions detected by each monitor remained similar even after accounting for confounders.These results suggest that uterine activity can be monitored from the vaginal interface in an ovine model and offers an alternative clinical tool for the detection of contractions in situations, in which tocodynamometry would be ineffective or intrauterine monitoring inappropriate.

El sufrimiento fetal agudo es un grave problema que se presenta en aproximadamente el 15% de las gestantes en trabajo de parto, produciendo una mortalidad perinatal elevada o lesiones neurológicas irreversibles si no se actúa a tiempo. Es por ello que las gestantes en peligro de desarrollar insuficiencia úteroplacentaria o portadoras de enfermedades crónicodegenerativas que alteren su homeostasis, deben ser vigiladas cercanamente para buscar signos de posible deterioro del producto. Uno de los cambios más impresionantes en obstetricia ha sido el empleo de parámetros biofísicos y bioquímicos en la valoración del bienestar fetal, lo que ha permitido identificar a los productos de riesgo y orientar el tratamiento, lográndose así disminuir los problemas perinatales. El empleo del monitoreo electrónico fetal permite evaluar el estado del producto de riesgo en el periodo prenatal a través de una prueba de contracción, así como en el intraparto, ya que en la mayor parte de los casos, la actividad uterina es el factor desencadenante del sufrimiento fetal, al sumarse a las otras causas o factores predisponentes.

El trabajo de parto es una actividad uterina rítmica y coordinada mediante la cual se logra la dilatación cervical progresiva que acaba por dilatar completamente el cuello uterino.

Se ha estudiado el efecto ocitócico, madurador del cuello uterino y acción potenciadora a la ocitocina del 17 -Beto Estradiol aplicada en cavidad amniótica en 10 gestantes de 38 o 40 semanas de gestación. Obteniéndose un aumento de la actividad uterina debido a un aumento en la intensidad y frecuencia de las contracciones, la maduración del cuello uterino en el 50 % de los casos y el gran aumento de la actividad uterina cuando se administra pequeñas dosis de ocitocina, demostrándose así el efecto potenciador que tiene esta hormona a la ocitocina.

This article presents the results of experimental investigation of opioid (opiate analgesics) influence on the nociceptive response of rat’s circulatory dynamics, breath and skeletal muscles tonus. The article demonstrates influence of opiate analgesics on intact and pregnant rat’s amplitude and frequency of uterine activity. The results of investigation of drug-induced effect of opiate analgesics in case of pregnant and in case of act of delivery model pain reaction were also described in this article.

Spontaneous haemoperitoneum in pregnancy (SHiP) due to endometriosis is a very rare condition and this is a case of a 41-year-old primigravida, who presented at 32 weeks with sudden onset of severe lower abdominal pain without any uterine activity. This was a dichorionic-diamniotic twin pregnancy, following in vitro fertilisation for subfertility secondary to severe endometriosis. On admission, pain score was eight, with ten being the maximum of the scale. The vital signs were stable. Abdominal palpation revealed generalised tenderness with no guarding or palpable contraction. There was no evidence of bleeding and the cervical os was closed on speculum examination. The cardiotocograph (CTG) was pathological and a plan was made to deliver the babies with emergency caesarean section. Intraoperatively, there was massive haemoperitoneum which was managed successfully with the involvement of multidisciplinary input from general surgeons and urologists with optimum maternal and fetal outcome.

Unlike many conditions in medicine, the classification of painful menstruation into primary and secondary dysmenorrhea is not based on the temporal appearance of symptoms or the condition, as it is in primary and secondary amenorrhea, or primary and secondary infertility. The taxonomy of primary and secondary dysmenorrhea is based upon the absence or presence (respectively) of clinically identifiable causes. In both cases, a great deal is known about the pathophysiology underlying the development of menstrual pain. It is, therefore, not an issue of a lack of identifiable causation; it is the lack of clinically identifiable processes that drive the assignment.

[EN] Labor induction is a common practice to promote uterine contractions and labor onset. Uterine electrohysterogram (EHG) has proved its suitability for characterizing the uterus electrophysiological condition in women with spontaneous labor. The aim of this study was to characterize and compare uterine myoelectrical activity during the first 4h in response to labor induction drugs, Misoprostol (G1) and Dinoprostone (G2), by analyzing the differences between women who achieved active phase of labor and those who did not (successful and failed inductions). A set of temporal, spectral and complexity parameters were computed from the EHG-bursts. As for successful inductions, statistical significant and sustained increases with respect to basal period were obtained for EHG amplitude, mean frequency, uterine activity index (UAI) and Teager, after 60¿ for the G1 group; duration, amplitude, number of contractions and UAI for the G2 group, after 120¿. Moreover, Teager showed statistical significant and sustained differences between successful and failed inductions (1.43±1.45 µV2.Hz2.105 vs. 0.40±0.26 µV2.Hz2.105 after 240¿) for the G1 group, but not in the G2 group, probably due to the slower pharmacokinetics of this drug. These results revealed that EHG could be useful for successful induction prediction in the early stages of induction, especially when using Misoprostol., This research project was supported by the Spanish Ministry of Economy and Competitiveness and the European Regional Development Fund (DPI2015-68397-R) and by the company Bial SA.

Uterine contraction is one of the most important indication in the labor progression. Electrohysterogram (EHG) is a promising method for monitoring uterine contraction and discriminating efficient and inefficient contractions. This study aims to analyze the difference of EHG signals between two groups. EHG signals are recorded with abdominal electrodes from 20 pregnant women, including 10 in term labor group and 10 in non-labor group. Typical linear and nonlinear characteristics of EHG signals, including root mean square (RMS), peak frequency (PF), median frequency (MDF), mean frequency (MNF), parameters from wavelet decomposition (W4, W5) and time reversibility (Tr) are extracted. These characteristics are compared between contraction and non-contraction in term labor group and non-labor group. The result shows that RMS, W4 and W5 of contraction are significantly larger than non-contraction both within term labor group and between two groups (all p

Missing samples are very common in fetal heart rate (FHR) recordings due to various reasons including fetal or maternal movements and misplaced electrodes. They introduce distortions and cause difficulties in their analysis. In this paper, we propose a Gaussian process-based method that can utilize other intrapartum signals (e.g., uterine activity and maternal heart rate) to recover the missing samples in FHR recordings. The proposed approach was tested on a short real FHR recording segment and its performance was compared with that of cubic spline interpolation which is widely used in pre-processing of FHR recordings. Our results show that the proposed approach, with utilization of UA signals, achieves 2.35 dB to 14.85 dB better recovery performance. Furthermore, even when the percentage of missing samples is more than 50%, the mean square error of this approach is still below one beat per minute.

Electrohysterogram source imaging, i.e., moving from the electrode/sensor space to the source space using EHG signals, provide an estimate of spatial distributions of uterine activity at millisecond scale. This paper aims to study the ability of different distributed source localization methods to recover uterine electrical activity sources. Performance was quantified using a detection accuracy index. Our result suggests that the variation based method is able to reconstruct extended uterus sources with the overall high accuracy, where the increasing of the electrodes numbers and the decreasing of the fat thickness induce a better accuracy in localization.

The assessment of uterine contractions is important in clinical decision-making, but the precise role for appraising contractions remains controversial. Four clinical approaches to assessing contractions are available: manual palpation; intrauterine pressure determination; external tocodynamometry; and electrohysterography. Palpation is inexpensive and harmless but requires the constant bedside presence of a trained observer. Intrauterine pressure measurement is considered the most sensitive and specific technique, and has become the standard by which other methods are judged; however, its quantitative measurements are not always precise or reproducible. Moreover, the availability of intrauterine pressure measurements does not seem to improve maternal or neonatal outcomes in most situations. External tocodynamometry is the most widely used technique. It is easy to apply and provides reasonably accurate information about the frequency and duration of contractions, but not their amplitude. It can require frequent adjustment during labor and might not work well in patients who are obese. Electrohysterography is a recently available noninvasive technology that detects uterine electrical activity using electrodes placed on the mother's abdominal wall. This approach is at least as reliable and accurate as tocodynamometry.

Successful pregnancy necessitates that the uterus is maintained in a relaxed, quiescent state for the majority of pregnancy, before being transformed to a contractile and excitable phenotype to facilitate parturition. There is now a substantial body of evidence highlighting key upstream regulators involved in this transformation. Despite our rapidly advancing knowledge of myometrial biology, the exact mechanisms that regulate parturition are not yet understood. Further work is necessary to define the complex interactions that form the key regulatory pathways controlling uterine quiescence, contractility, and the transition between the two states. Furthermore, new evidence continues to emerge implicating novel mechanisms that regulate uterine activity during normal and preterm birth. This review examines current evidence pertaining to key upstream regulators that have been implicated in human parturition over the past decades and surveys recent findings that are yet to be integrated into the paradigm of uterine regulation.

Objective: In this experimental study, we aimed to investigate the role of melatonin on uterine myoelectrical activity of non-pregnant rats.Material and Methods: Forty-six female rats were assigned to six groups: (1) control; (0.2 mL 0.9% NaCl was injected intravenously (IV), n=6); (2) melatonin applied as 0.4 mg/kg/IV (n=8); (3) melatonin applied as 4 mg/kg/IV (n=8); (4) single dose of oxytocin (100 mU/kg) injected IV (n=8); (5) melatonin (0.4 mg/kg) plus oxytocin (100 mU/kg) (n=8); and (6) melatonin (4 mg/kg) plus oxytocin (100 mU/kg) injected IV (n=8). Each rat underwent a laparotomy, and uterine myoelectrical signals were recorded. The mean spectrum, averaged over the spectral content of signals in each group, was compared.Results: Melatonin induced uterine myoelectrical activity in a dose-dependent manner. Treatment of melatonin after oxytocin suppressed the mean power of the signals. Serum melatonin concentrations were significantly higher in melatonin-treated rats.Hypoparathyroidism, deafness, and renal dysplasia (HDR; OMIM 146255) syndrome is a rare disease, inherited dominantly and found to be related with GATA3 (GATA binding protein 3) gene mutations. A 13-year and 8-month-old boy who presented with hypocalcemia was diagnosed with hypoparathyroidism. He also had dysmorphic facial features, renal anomaly (pelvic kidney), and mild sensorineural hearing loss. His cranial computed tomography revealed multiple calcifications in bilateral centrum semiovale, corona radiata, and basal ganglions suggesting a persistent hypoparathyroidism. Thus, the presence of triad of HDR syndrome was considered, and genetic analysis using a next-generation sequencer identified a novel de novo missense mutation in exon 4 p.R276Q (c.827G>A) of GATA3 gene. This is the second patient who was reported to have a mutation in GATA3 gene from Turkey. In conclusion, although HDR syndrome is a rare condition, it should be kept in mind in patients with hypoparathyroidism. Classical triad can easily be identified if patients diagnosed with hypoparathyroidism are also evaluated with a urinary tract ultrasound and an audiometer.

New Findings What is the topic of this review? How do medicinal plants act on the myometrium? What are the underlying mechanisms whereby medicinal plants exert their effects? What advances does it highlight? We show that medicinal plants can affect uterine contraction at many loci. These studies give us a better understanding of how medicinal plants work on the uterus and can be applied in other areas of smooth muscle physiology, as well as pharmacy and medicine. This knowledge is also useful for developing new agents with potential to improve women's reproductive and gynaecological heath. This report summarizes work investigating the effects of some medicinal plants on uterine contraction. As there is a clinical need to find better drugs to help control uterine activity, and novel compounds are sought, the mechanisms whereby the medicinal plants exert their effects, as well as their major compounds, are discussed. By identifying the plants, major constituents and mechanisms, this review also illustrates the potential for development of new drugs, so that better ways to treat uterine disorders will be available to women worldwide.

The efficiency of osteopathy methods is carried out by preparation of pregnant organism for labor. 65 pregnants were included in research with full-term pregnancy, without heavy somatic and obstetric complications. Pregnants at whom as complex preparation for labor along with medicine therapy (spazmolytics, laminarias, antygestagenes, physical therapy) were applied osteopathic methods were included In the main group (n = 36). In group of comparison (n = 29) only medicine therapy was applied. At women in labor who have received complex preparation for labor with the use of osteopathic techniques in comparison with group, receiving only medicine therapy, the increase in speed of uterine cervix dilatation at 0.2 cm/h in latent and active phases of labor, reliable decrease in frequency of uterine activity anomalies and fetal hypoxia, and, as a result, decrease by 3 times of emergent Cesarean section frequency is detected. Decrease in frequency of perineotomiya and ruptures of uterine cervix are noted.

We performed an analysis of 85 histories of labor. Depending on perinatal outcome and application of uterotonics all stories of labor were divided into 3 groups. We present typical signs and shapes of uterine activity hyperstimulation in the application of uterotonic in labor. We established that with the appearance of any signs of hyperstimulation, it is necessary to limit or suspend the infusion of drug or to revise the plan of labor conduction in favor of the Cesarean section.