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This Article Full Text Full Text (PDF) All Versions of this Article: 92/4/621    most recent expphysiol.2007.038125v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wray, S. Search for Related Content PubMed PubMed Citation Articles by Wray, S.

¹ Department of Physiology, University of Liverpool, Crown Street, Liverpool L69 3BX, UK

Abstract

A better understanding of the mechanisms that generate and modulate uterine contractility is needed if progress is to be made in the prevention or treatment of problems in labour. Dysfunctional labour describes the condition when uterine contractility is too poor to dilate the cervix, and it is the leading cause of emergency Caesarean sections. Recently, insight has been gained into a possible causal mechanism for dysfunctional labour. Study of the physiological mechanisms that produce excitation in the uterus, the subsequent Ca²⁺ signals and biochemical pathway leading to contraction has underpinned this progress. In this review, I give an account of excitation–contraction signalling in the myometrium and explore the implications of recent findings concerning lipid rafts for these processes. I also discuss how changes of pH are fundamentally enmeshed in uterine activity and biochemistry and explore the effect that pH changes will have on human myometrium. Finally, I present the evidence that acidification of the myometrium is correlated with dysfunctional labour and suggest the processes by which it is occurring. It is only by gaining a better understanding of uterine physiology and pathophysiology that progress will be made and research findings translated into clinical benefit for women and their families.

(Received 10 April 2007; accepted after revision 26 April 2007; first published online 1 April 2007)
Corresponding author S. Wray: Department of Physiology, University of Liverpool, Crown Street, Liverpool L69 3BX, UK. Email: s.wray{at}liverpool.ac.uk

The Joan Mott Prize Lecture was given at the UK Physiological Society meeting at UCL on 6th July 2006.

This article is dedicated to the memory of Professor Robert Harkness (1917–2006), supervisor, friend and scholar.