Pathophysiology of preterm labour.
A specific pathogenic process of premature delivery represents the inflammation. Birth canal infections seem to play a key role in the ethiopathogenesis of premature delivery; the related biochemical changes significantly affect perinatal morbidity and mortality. Other potential causes, particularly hormone metabolism disorders or uteroplacental ischaemia have been intensively studied. This process is related both to the mother and fetus. Fetal inflammatory response (FIRS)--can occur without maternal response--and it is related to a significant increase in perinatal morbidity. FIRS has definite laboratory, histological and clinical criteria. Effective primary prevention of premature delivery does not exist at present. The sensitivity and specificity of so far used laboratory markers is low. Thus, the research is focused on finding new inflammation markers allowing the early identification of pregnant women at a high risk of premature delivery and fetal inflammation. The screening of women at a high risk by means of new laboratory and ultrasound tests belongs to the most important steps in secondary and tertiary prevention of premature delivery. Intensive research of potential trigger mechanisms has been carried out, including a variety of gene types, which are potentially related to the process of premature delivery.
Koucký
M
M
Charles University in Prague, First Faculty of Medicine and General Teaching Hospital, Department of Gynaecology and Obstetrics, Apolinárská 18, 128 00 Prague 2, Czech Republic. michalkoucky@seznam.cz
Germanová
A
A
Hájek
Z
Z
Parízek
A
A
Kalousová
M
M
Kopecký
P
P
D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000209:etiology / Q000503:physiopathology*; D011247:Pregnancy