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What causes labour in women?. Can we predict it?. Professor A López Bernal University of Bristol Department of Clinical Sciences at South Bristol. Preterm birth remains the major cause of neonatal mortality and morbidity. 100. 80. 60. Survival. %. 40. Disability. 20. 0. 23. 24. 25.
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What causes labour in women? Can we predict it? Professor A López Bernal University of Bristol Department of Clinical Sciences at South Bristol
Preterm birth remains the major cause of neonatal mortality and morbidity 100 80 60 Survival % 40 Disability 20 0 23 24 25 26 Weeks of gestation The horizontal bars represent the mean and the vertical bars represent 95% C.I. Morrison & Rennie, 1997 Br J Obstet Gynaecol 104, 1341-1350. Marlow et al. 2005. N Eng J Med; 352: 9-19
Fetal blood Myometrium Amniotic fluid Choriodecidua interface Cervical secretions Signals for the physiological onset of labour Pathophysiology of preterm labour? Maternal compartment A López Bernal
Identification of labour associated proteins in the human uterus Term Preterm A López Bernal
Signalling pathways that regulate contractility Calcium waves in human myometrial cells A López Bernal
We need to improve the management of preterm labour to decrease neonatal mortality and morbidity Search for biomarkers to predict labour Further research into factors controlling the onset of labour is essential