title: Endocrinology of human parturition.
abstract: The mechanisms involved in human pregnancy maintenance and parturition are highly complex and involve mother, fetus and placenta. The "final common pathway" to delivery is composed by inflammatory and endocrine interactive paths that tip the balance in favor of coordinated uterine contractility and cervical dilation. These mechanisms involve a shift from progesterone to estrogen dominance, CRH action, increased sensitivity to oxytocin, gap junction formation, and increased prostaglandins activity. Complementary changes in the cervix involve a decrease in progesterone dominance and the actions of prostaglandins and relaxin, via connective tissue alterations, leading to cervical softening and dilation. Neuronal, hormonal, inflammatory and immune pathways participate in initiation of labor and the utero-placental unit plays a major role in the synthesis and release of parturition mediators.
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, "S. Maria alle Scotte", viale Bracci, 53100 Siena, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Vannuccini
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, "S. Maria alle Scotte", viale Bracci, 53100 Siena, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Bocchi
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, "S. Maria alle Scotte", viale Bracci, 53100 Siena, Italy.
authors.forename: Filiberto M
authors.initials: FM
authors.lastname: Severi
authors.affiliation: The University of Western Australia M460A, 35, Stirling Highway, Crawley, WA 6009, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Challis
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, "S. Maria alle Scotte", viale Bracci, 53100 Siena, Italy. Electronic address: felice.petraglia@unisi.it.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D004967:Estrogens / Q000378:metabolism / Q000502:physiology; D005260:Female; D005333:Fetus / Q000378:metabolism; D006728:Hormones / Q000378:metabolism / Q000502:physiology*; D006801:Humans; D036801:Parturition / Q000502:physiology*; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D011374:Progesterone / Q000378:metabolism / Q000502:physiology; D011453:Prostaglandins / Q000378:metabolism / Q000502:physiology
chemical_list: D004967:Estrogens; D006728:Hormones; D011453:Prostaglandins; D011374:Progesterone
keywords: Accouchement; CRH; Estrogens; Estrogènes; Parturition; Placenta; Progesterone; Progestérone; Prostaglandines; Prostaglandins; Relaxin; Relaxine; Urocortin; Urocortines