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Fiziologia Mm. Uterin in Travaliu (Eng)
Fiziologia Mm. Uterin in Travaliu (Eng)
LABOR
The uterus in prepared for labor by progressive morphological and functional
changes during pregnancy (chapter 13). Hypertrophy and dilatation (with limited
appearance of new muscle cells) as well as changes in connective tissue, blood vessels,
lymphatics and nerves have, beyond accommodation of fetus, one major aim: to make
ready the organ for the work and mechanics of delivery. There is a high degree of morpho-
functional integration: muscular cells are changed, the whole environment is adapted and
the connective tissue ensures the transmission of contraction.
Estrogens stimulate uterine hyperplasia / hypertrophy. Together with progesterone
and chronic myometrial stretching (due to the fetal growth), they stimulate actomyosin and
collagen synthesis in a synergic manner.
P-Actomyosin (ATPase)
ATP ADP
V. Myometrial contractility
Cellular, anatomical and physiological characteristics of myometrial muscle induce
unique features for increasing the efficiency of uterine contractions and of the delivery
mechanics:
The contraction may be of one order of magnitude greater than that attained in
striated muscle cells;
Forces can be exerted in any direction;
Intracellular arrangement of thin and in thick filaments / long, random bundles
induces greater shortening / higher force-generating capacity;
The network disposal and the spindle shape of the myometrial cells allow
multidirectional force generation.