Received April 10, 2007
Revised April 26, 2007
Accepted after revision April 26, 2007

¹ University of Liverpool

^* To whom correspondence should be addressed. E-mail: s.wray{at}liverpool.ac.uk.

	Abstract

A better understanding of the mechanisms generating and modulating uterine contractility is needed if progress is to be made in preventing or treating 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 mechanism causing dysfunctional labour. Studying the physiological mechanisms producing excitation in the uterus, the subsequent Ca 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 pH changes will have on human myometrium. Finally I present the evidence that acidification of the myometrium is correlated with dysfunctional labours and suggest the processes by which it is occurring. It is only by gaining a better understanding of uterine physiology and patho-physiology that progress will be made and research findings translated to clinical benefit for women and their families.

Key Words: Hormones, Muscle contraction, Uterus