Malfunction in Either the Inhibitory System or Stimulatory System, or
Both, Changes the Timing of Birth or Mode of Delivery: A Hypothesis IV
Abstract
Objective: Spontaneous preterm birth is the leading global cause of
neonatal death, and countless efforts have failed to establish a single
effective treatment for preterm labor. Labor dystocia is the major cause
of primary cesarean delivery; however, its biological mechanisms during
labor are poorly understood. When post-term pregnancy truly exists the
cause is usually unknown. The objective of the study tries to identify
the possible cause of these obstetric complications Design: Research
Study Setting: Portiuncula University Hospital, Ireland Population: N/A
Methods: This study investigated the current evidence-based literature
that may support the hypothesis. Main Outcome Measures: N/A Results:
Obstetric literature is replete with overwhelming evidence that
malfunction of any exponential uterine wall tension (EUWT) component
(stretch-dependent inhibitory system) terminates the pregnancy. Most of
the current therapeutic preterm strategies are focused on preventing
premature EUWT failure e.g. the cervical stitch. Progesterone treatment
for preterm labor may be working by enhancing the stretch-dependent
inhibitory system by modulating uterine wall plasticity and EUWT.
Post-term pregnancy is due to the failure of the stimulatory system to
transform the cervix into the lower uterine segment and to lose its
resistance that terminating the pregnancy at full term. A combined
malfunction of the two systems causes labor dystocia e.g rupture of
fetal membranes with a long cervix. Conclusion: There is growing
evidence to support the hypothesis that malfunction of the inhibitory
system causes preterm labor, malfunction of the stimulatory system
causes post-term pregnancy and labor dystocia is due to a combined
malfunction of the two systems.