Term Labor Research Articles

Economics of Rice Production and Marketing in Nigeria: A Study of Ebonyi State

This study examines the economics of rice production and marketing in Nigeria. The costs and returns, marketing margin, and constraints associated with rice production and marketing were examined. Seven states and nine markets were selected for investigations. Stratified random sampling techniques were used to collect data from forty-five respondents. The simple descriptive statistics and farm firm budget techniques were the major tools used in analyzing the data. Result of the analysis showed that the rice Farmers made a 68% gross income while the net income was at 43% which is indicative that the middlemen did not make excessive profit at the expense of the primary producers. Constraints associated with rice production include high cost of labour and inputs in terms of machinery while that of marketing included high cost of transportation and inadequate storage facilities. The study suggests an improvement of Farm inputs and equipment, the road network system and provision of agricultural credit to enable rice farmers and traders expand the volume of their operations.The choice of these towns was based on the fact that they have the highest concentration of the rice farmers, Rice Mills and onsumers in the State. The swampy and soft nature of the most part of those areas makes cultivation easy. In the researcher’s research project, simple random sampling techniques was used to select the sample for this study. This was mainly to ensure that the sample was truly the representation of the total population. Each of the thirteen towns and markets were given an equal opportunity of appearing in the experiment. It sets also to study benchmark of activity or performance of a given equity market – the relationship between domestic or circular market and its contribution to making Nigeria a vibrant economy.

Role of isosorbide mononitrate in induction of labour: A single arm clinical trial at a tertiary care hospital

Introduction and Aim:Isosorbide mononitrate, a nitric oxide donor, induces the enzyme cyclo-oxygenase-2, leading to production of local prostaglandins in human cervix and leads to structural rearrangement of the collagen network and thereby the cervix ripens.The aim of this study was to determine the role of Isosorbide mononitrate in induction of labour, determine induction delivery interval and obstetric and neonatal outcome.
 
 Materials and Methods:This study was an interventional study on 40 pregnant women conducted for a period of one year. Women requiring induction of labour, who met the inclusion criteria, were enrolled. Isosorbide mononitrate (40 milligrams) was inserted in the posterior fornix. If Bishop's score did not change after 24 hours of the initial dose, failure of induction of labour was considered.Those patients in whom labour pains started after isosorbide mononitrate alone were considered to be in successful group(A) while those who required additional drugs like prostaglandins were considered to be in the failed group(F).
 
 Results:The mean (SD) Bishop score after 1dose of isosorbide mononitrate in the successful group (A) was 6.04 (2.16) and in the failed group (F) was 3.81 (0.83). There was a significant difference in terms of Bishop Score after 1st Dose of IMN (W = 310.000, p = 0.001) and in terms of induction-delivery time in hours (t = -2.386, p = 0.023).
 
 Conclusion:This study concludes that Isosorbide mononitrate has significant role for induction of labor in terms of Bishop score changes and induction delivery interval.

Ultrasound Assessment of Fetal Adrenal Gland in Term and Preterm Labor Cases

Background: Preterm birth (PTB) remains a major cause of perinatal morbidity and mortality worldwide. Compared with term deliveries, early PTB (< 34 weeks' gestation) carries a 7-fold increased risk of neonatal death. Objective: To compare the Fetal Zone Depth (FZD) of fetal adrenal gland in term and preterm labor cases Patients and Methods: Thirty-three preterm pregnant women at 29-36 weeks of gestation with single pregnancy and clinical diagnosis of preterm labor and control group of 33 pregnant women at 37-40 weeks with term pregnancy were included in this study. FZD and Total Gland Depth (TGD) of fetal adrenal gland were ultrasonographically measured and FZD/TGD ratios were calculated and compared between the two groups. Results: No difference was found between the two groups in respect of age and number of pregnancies (P > 0.05). Yet, preterm birth history rupture of membrane, cervical dilatation and mode of delivery were higher in preterm group (P <0.05). Fetal adrenal gland FZD/TGD ratio was statistically significantly higher in preterm group compared to the term group (52% ± 5% vs. 29% ±9%; P <0.001). Conclusion: The growth in FZ as a fetal adaptation mechanism in increased fetal stress in preterm labor cases was at a significant level. Once supported by more comprehensive studies, we think that this result would be beneficial in the prediction of preterm labor in clinical practice.

EFFECT OF MATERNAL BODY MASS INDEX ON PROGRESS AND OUTCOME OF LABOR IN NULLIPAROUS PREGNANT WOMEN

Background: Obesity is a widely spread health problem the complications of which are too many whether general or obstetric complications. Objective: The aim of this observational study is to evaluate the impact of increased BMI of nulliparous women on progress of labor, incidence of peri-partum complications (1ry outcome) and neonatal outcome of these women (secondary outcome). Patients and Methods: In this prospective observational study, 150 primigravidas in labor were recruited in Mit Ghamr General Hospital between November 1st, 2019 and April 30th, 2020 and categorized into 5 groups according to WHO BMI classification; Group A contained 50 patients with BMI 18.9-24.9, group B 50 patients with BMI 25-29.9, group C1 20 patients with BMI 30-34.9, group C2 20 patients with BMI 35-39.9 and group C3 10 patients with BMI at least 40. Recruited patients were monitored for their progress of labor (in terms of time of cervical dilation from 4 cm to 10 cm, the accordingly calculated rate of cervical dilation and duration of head descent) and their development of peri-partum complications (cervical dystocia, shoulder dystocia, arrest of head descent, the subsequent potential need for CS, 3rd and 4th degree perineal tears, 1ry post-partum hemorrhage, retained placenta). Neonatal outcome was observed by measuring fetal birth weight, APGAR score at 1 minute and 5 minutes, subsequent potential need for NICU admission and occurance of neonatal jaundice. Results: A statistically significant difference was found regarding progress of labor and neonatal outcome with women in obese groups (C1, C2, C3) having slower progress and worse neonatal outcome, while no statistically significant difference was found regarding mode of delivery and peri-partum complications. Conclusion: Obese women in labor considered high-risk cases that required special measures whether on short-term or long-term basis.

Using quantitative fetal fibronectin to predict term labour onset in Australian rural women: A pilot study.

Many women living in rural and remote Australia are required to travel large distances to birth in a hospital with maternity facilities, incurring considerable financial, social and emotional burden for them and their families. No studies to date have investigated the use of quantitative fetal fibronectin (qfFN) to predict term labour in asymptomatic pregnant women. A tool which is able to more accurately predict term labour has the potential to guide informed travel decision-making for women and healthcare professionals in rural and remote Australia. The aim of this study is to determine if qfFN can reliably predict term labour in asymptomatic women from rural and remote areas. Thirty-nine women from rural Australia provided 71 fFN samples between June 2016 and October 2018, from 37weeks' gestation, with at least one week between samples for those providing multiple samples. Days from fFN sampling until spontaneous onset of labour were recorded. Using generalised estimating equation modelling we examined the utility of fFN as a predictor for onset of labour at term after adjusting for confounders. There was a small-to-moderate negative correlation (rs -0.27, P<0.05) between time until labour and fFN. Quantitative fFN was observed to be a significant predictor of time until labour after adjusting for confounding variables (P<0.001). fFN levels may play a role in predicting term labour in rural women; however, future studies with a larger sample size are required to validate the findings of our pilot study.

PKA and AKIP1 interact to mediate cAMP-driven COX-2 expression: A potentially pivotal interaction in preterm and term labour.

Previously, we showed that cAMP increased COX-2 expression in myometrial cells via MAPK. Here, we have extended these observations, using primary myometrial cell cultures to show that the cAMP agonist, forskolin, enhances IL-1β-driven COX-2 expression. We then explored the role of A-kinase interacting protein (AKIP1), which modulates the effect of PKA on p65 activation. AKIP1 knockdown reversed the effect of forskolin, such that its addition inhibited IL-1β-induced COX-2 mRNA expression and reduced the IL-1β-induced increase in nuclear levels of p65 and c-jun. Forskolin alone and with IL-1β increased IκBα mRNA expression suggesting that in the context of inflammation and in the presence of AKIP1, cAMP enhances p65 activation. AKIP1 knockdown reversed these changes. Interestingly, AKIP1 knockdown had minimal effect on the ability of forskolin to repress either basal OTR expression or IL-1β-stimulated OTR mRNA expression. AKIP1 was up-regulated by IL-1β, but not stretch and was repressed by cAMP. The mRNA expression of AKIP1 increased in early labour in tandem with an increase in COX-2 mRNA and protein. AKIP1 protein levels were also increased with inflammation and stretch-induced preterm labour. Our results identify a second important cAMP effector-switch occurring at term in human myometrium and suggest that a hitherto unrecognized interaction may exist between AKIP1, NFκB and AP-1. These data add to the proposition that cAMP acts as a key regulator of human myometrial contractility.

Oxidative Stress Induced Damage and Early Senescence in Preterm Placenta.

Introduction Senescent cells have been demonstrated to release High Mobility Group Box 1 (HMGB1) which induces labor through an inflammatory pathway. This research is aimed at demonstrating whether telomere shortening, proinflammatory HMGB1, and oxidative damage marker 8-OHdG play a role in the placenta of preterm birth in comparison to term birth. Method A cross-sectional study on 67 full thickness of the placenta obtained from mothers with term and preterm birth. Mothers with clinical signs of infection (fever > 38°C, leukocytosis > 18000/μL, or abnormal vaginal discharge) and other pregnancy complications were excluded. Real-time polymerase chain reaction was performed to measure T/S ratio and ELISA quantification to measure the amount of HMGB1 and 8-OHdG. Result A total of 34 placentas from preterm and 33 placentas from term birth were examined. Maternal characteristics were comparable between the two groups. There were no statistical difference of T/S ratio (p = 0.181), HMGB1 (p = 0.119), and 8-OHdG (p = 0.144) between the preterm and term groups. HMGB1 was moderately correlated with 8-OHdG (r = 0.314). Telomere T/S ratio of the placenta did not differ between preterm and term labor despite difference in gestational age, suggesting earlier shortening in the preterm group. It is possible that critical telomere length has been achieved in both term and preterm placenta that warrants labor through senescence process. The result of our study also showed that HMGB1 was not correlated to telomere length, due to the fact that HMGB1 is not upregulated until the critical length of telomere for senescence is exhibited. Conclusion Similar telomere length might be exhibited due to early telomere shortening in preterm birth that mimics the term placenta. The relationship between placental telomere shortening and HMGB1 release remains to be uncovered. Further research is needed to discover the factors leading to early telomere shortening in the placenta of preterm birth.

“Relaxin-dependent” way of implementing spontaneous preterm labor in multiple pregnancies: The involvement of placental relaxin 2

BACKGROUND: Despite numerous studies, the etiopathogenesis of preterm birth in multiple pregnancy remains unclear, which determines the low effectiveness of measures for the prevention of preterm birth. This fact makes it necessary to study possible ways of implementing preterm birth in multiple pregnancies and to search for new biomarkers of their pathogenetic links. Experimental and clinical studies have demonstrated the contribution of the pleiotropic hormone relaxin to the regulation of a wide range of physiological processes and its role in the implementation of the pathogenetic mechanisms of pregnancy complications, primarily premature birth. The proven autocrine / paracrine mechanism of placental relaxin action, which implements important local effects, determines the prospects for studying the contribution of its dysregulation to the implementation of spontaneous preterm labor in multiple pregnancies.&#x0D; MATERIALS AND METHODS: A morphological examination of 92 placentas from 46 deliveries of dichorionic diamniotic twins was performed: 24 of them were spontaneous premature births and 22 spontaneous term births. Histological examination of placentas along with immunohistochemical verification of relaxin 2 expression in the chorionic villus of the dichorial twins placentas were carried out.&#x0D; RESULTS: Histological examination of the dichorionic twins placentas revealed that those from spontaneous preterm birth were characterized by a higher frequency of chronic placental insufficiency with reduced compensatory and adaptive mechanisms and more pronounced circulatory disorders in the circulatory bed of the villous tree, when compared to placentas from spontaneous term labor. The first verification of relaxin 2 expression in the chorionic villi of the dichorionic twins placenta showed the role of the peptide in the initiation of spontaneous preterm birth. The relative area of relaxin 2 expression in spontaneous preterm labor was significantly higher (p 0.05) compared to that in spontaneous term labor.&#x0D; CONCLUSIONS: The data obtained confirm the hypothesis put forward about the involvement of placental relaxin in the pathogenesis of spontaneous preterm labor in multiple pregnancies. The authors were the first to propose the definition of a relaxin-dependent way of implementing spontaneous preterm labor. To help define new preventive strategies, the prospects for further studies of the role and significance of relaxin in the implementation of pathogenic processes involved in spontaneous preterm birth in multiple pregnancies have been outlined.

Endocannabinoid System in Pregnancy Maintenance and Labor: A Mini-Review.

The endocannabinoid system (ECS) is a cell-signaling system present in multiple organ systems and is an integral part of sustaining the microenvironment necessary for early pregnancy success and maintenance. It plays a significant role in embryo development, transport and implantation as well as placentation. The current theory behind the initiation of term labor is that it is a complex, multifactorial process involving sex steroid hormones, prostaglandin production and interplay at the maternal-fetal interface resulting in increased expression of receptors and gap junctions that promote uterine activation. There is increasing evidence that, in addition to early pregnancy events, the ECS plays a regulatory role in pregnancy maintenance and the timing of labor. This review presents an overview of the ECS in pregnancy that focuses on late gestation and parturition.

Pro‐inflammatory signals induce 20α‐HSD expression in myometrial cells: A key mechanism for local progesterone withdrawal

Metabolism of progesterone (P4) by the enzyme 20α hydroxysteroid dehydrogenase (20α‐HSD) in myometrial cells is postulated to be a mechanism for P4 withdrawal, which occurs concomitant to uterine inflammation (physiologic or infection‐induced) and associated activation of transcription factors: NF‐кB and AP‐1, common to term and preterm labour. We found that 20α‐HSD protein is significantly increased in human myometrium during term labour, and in mouse uterus during term and preterm labour. Treatment of human myometrial cells with the pro‐inflammatory mediators, lipopolysaccharide (LPS, mimicking infection) and 12‐O‐tetradecanoylphorbol‐13‐acetate (TPA, mimicking inflammation), induced 20α‐HSD gene expression and increased 20α‐HSD protein abundance. LPS treatment decreased P4 release into the culture medium and resulted in up‐regulation of GJA1 in the hTERT‐HM cells. The NF‐кB /AP‐1 transcription factors mediated effects of LPS and TPA on 20α‐HSD gene transcription. Both pro‐inflammatory stimuli induced 20α‐HSD promoter activity in LPS/TPA‐treated cells which was significantly attenuated by inhibition of NF‐кB (JSH: 20 µM) or AP‐1 signalling (T5224: 10 µM). Deletion of NF‐кB consensus sites abrogated LPS‐mediated promoter induction, while removal of AP‐1 sites reversed the TPA‐mediated induction of 20α‐HSD promoter. We conclude that inflammatory stimuli (physiologic or pathologic) that activate NF‐кB or AP‐1 induce 20α‐HSD transcription and subsequent local P4 withdrawal resulting in up‐regulation of GJA1 and activation of myometrium that precedes labour.

Hydrogen Sulfide Contributes to Uterine Quiescence Through Inhibition of NLRP3 Inflammasome Activation by Suppressing the TLR4/NF-κB Signalling Pathway.

BackgroundThe NLRP3 inflammasome plays a critical role in inflammatory responses in various diseases. Our previous study showed that NLRP3 expression was significantly increased in human pregnancy tissue during term labour. Therefore, we explored whether NLRP3 participated in inflammatory responses of preterm and term labour and whether this process could be relieved by H2S, one anti-inflammatory gasotransmitter.MethodsHuman myometrium was obtained from non-labouring and labouring women. Mouse myometrium was obtained from LPS-induced infectious preterm labour. Uterine smooth muscle cells were isolated from non-labouring women’s myometrial tissues, transfected with siRNA, and treated cells with IL-1β, H2S donor NaHS, NF-κB inhibitor BAY 11–7082 and TLR4 inhibitorTAK-242. The NLRP3 inflammasome, CSE, CBS, TLR4, uterine contraction-associated proteins (CAPs), NF-κB activation and inflammatory cytokine expression were assessed by Western blotting and RT-PCR.ResultsThe NLRP3 inflammasome, TLR4 and activated NF-κB expression were upregulated in human term labour, mouse preterm labour and human uterine smooth muscle cells treated with IL-1β. NLRP3 levels were negatively correlated with CSE and CBS expression. Treatment with the H2S donor NaHS delayed LPS-induced preterm birth in mice and inhibited NLRP3 inflammasome activation. In siNLRP3-transfected cells, there was a significant decrease in the expression of CAPs and inflammatory cytokines compared with IL-1β stimulation. In addition, treatment with the H2S donor NaHS inhibited NLRP3 inflammasome activation, reduced the expression of uterine contraction-associated proteins and inflammatory cytokines and reduced the activation of TLR4 and NF-κB compared with stimulation with IL-1β in human uterine smooth muscle cells. Furthermore, treatment of uterine smooth muscle cells with BAY 11–7082 and TAK-242 found that NLRP3 activation was regulated by the TLR4 and NF-κB pathways.ConclusionH2S suppresses CAP expression and the inflammatory response and contributes to uterine quiescence by inhibiting the TLR4/NF-κB signalling pathway and downstream NLRP3 inflammasome activation. Thus, H2S contributes to uterine quiescence through inhibition of NLRP3 inflammasome activation by suppressing the TLR4/NF-κB signalling pathway.

TBX2, a Novel Regulator of Labour.

Background and Objectives: Therapeutic interventions targeting molecular factors involved in the transition from uterine quiescence to overt labour are not substantially reducing the rate of spontaneous preterm labour. The identification of novel rational therapeutic targets are essential to prevent the most common cause of neonatal mortality. Based on our previous work showing that Tbx2 (T-Box transcription factor 2) is a putative upstream regulator preceding progesterone withdrawal in mouse myometrium, we now investigate the role of TBX2 in human myometrium. Materials and Methods: RNA microarray analysis of (A) preterm human myometrium samples and (B) myometrial cells overexpressing TBX2 in vitro, combined with subsequent analysis of the two publicly available datasets of (C) Chan et al. and (D) Sharp et al. The effect of TBX2 overexpression on cytokines/chemokines secreted to the myometrium cell culture medium were determined by Luminex assay. Results: Analysis shows that overexpression of TBX2 in myometrial cells results in downregulation of TNFα- and interferon signalling. This downregulation is consistent with the decreased expression of cytokines and chemokines of which a subset has been previously associated with the inflammatory pathways relevant for human labour. In contrast, CXCL5 (C-X-C motif chemokine ligand 5), CCL21 and IL-6 (Interleukin 6), previously reported in relation to parturition, do not seem to be under TBX2 control. The combined bioinformatical analysis of the four mRNA datasets identifies a subset of upstream regulators common to both preterm and term labour under control of TBX2. Surprisingly, TBX2 mRNA levels are increased in preterm contractile myometrium. Conclusions: We identified a subset of upstream regulators common to both preterm and term labour that are activated in labour and repressed by TBX2. The increased TBX2 mRNA expression in myometrium collected during a preterm caesarean section while in spontaneous preterm labour compared to tissue harvested during iatrogenic preterm delivery does not fit the bioinformatical model. We can only explain this by speculating that the in vivo activity of TBX2 in human myometrium depends not only on the TBX2 expression levels but also on levels of the accessory proteins necessary for TBX2 activity.

Determination of misoprostol acid in plasma samples by UPLC–MS/MS with application in a maternal-fetal pharmacokinetic study following a low misoprostol dose vaginally to induce labor

Misoprostol is a prostaglandin E1 synthetic analogous used for elective interruptions of early pregnancy, treatment of incomplete abortion, postpartum hemorrhage and induction of full-term labor. Its a lipophilic drug, passing by extensive and rapid pre-systemic metabolism into the active metabolite, misoprostol acid (MA). The objective of this study was to develop and validate a highly sensitive method for MA determination in plasma using UPLC-MSMS, with application in a study of maternal-fetal pharmacokinetics in healthy parturients women (n = 10) after administration of 25 μg misoprostol vaginally. The method presented linearity of 2−10 pg/mL and acceptable precision, accuracy, plasma and solution stability. The parturients women presented median (interquartile range) values of AUC0−6 of 68.0 (40.8–84.7) pg.h/mL, Cmax of 21.9 (11.9–30.1) pg/mL and Tmax of 2.25 (0.69–5.00) h. The placental transfer of MA was assessed from the umbilical vein/maternal blood ratios of 1.40 (0.91–2.13) and intervillous space/maternal blood ratios of 0.49 (0.15–3.41). In conclusion, this method presented high sensitivity, being able to quantify MA in plasma samples following a low 25 μg misoprostol administered vaginally aimed to induce labor in parturients women. Additionally, this is the first description of the placental transfer of MA after a vaginal administration of misoprostol.

Equine cervical remodeling during placentitis and the prepartum period: a transcriptomic approach

Cervical remodeling is a critical component in both term and preterm labor in eutherian mammals. However, the molecular mechanisms underlying cervical remodeling remain poorly understood in the mare. The current study compared the transcriptome of the equine cervix (cervical mucosa (CM) and stroma (CS)) during placentitis (placentitis group, n = 5) and normal prepartum mares (prepartum group, n = 3) to normal pregnant mares (control group, n = 4). Transcriptome analysis identified differentially expressed genes (DEGs) during placentitis (5310 in CM and 907 in CS) and during the normal prepartum period (189 in CM and 78 in CS). Our study revealed that cervical remodeling during placentitis was dominated by inflammatory signaling as reflected by the overrepresented toll-like receptor signaling, interleukin signaling, T cell activation, and B cell activation pathways. These pathways were accompanied by upregulation of several proteases, including matrix metalloproteinases (MMP1, MMP2, and MMP9), cathepsins (CTSB, CTSC, and CTSD) and a disintegrin and metalloproteinase with thrombospondin type 1 motifs (ADAMTS1, ADAMTS4, and ADAMTS5), which are crucial for degradation of cervical collagens during remodeling. Cervical remodeling during placentitis was also associated with upregulation of water channel-related transcripts (AQP9 and RLN), angiogenesis-related transcripts (NOS3, ENG1, THBS1, and RAC2), and aggrecan (ACAN), a hydrophilic glucosaminoglycan, with subsequent cervical hydration. The normal prepartum cervix was associated with upregulation of ADAMTS1, ADAMTS4, NOS3 and THBS1, which might reflect an early stage of cervical remodeling taking place in preparation for labor. In conclusion, our findings revealed the possible key regulators and mechanisms underlying equine cervical remodeling during placentitis and the normal prepartum period.

Molecular signatures of labor and nonlabor myometrium with parsimonious classification from 2 calcium transporter genes.

Clinical phenotyping of term and preterm labor is imprecise, and disagreement persists on categorization relative to underlying pathobiology, which remains poorly understood. We performed RNA sequencing (RNA-seq) of 31 specimens of human uterine myometrium from 10 term and 21 preterm cesarean deliveries with rich clinical context information. A molecular signature of 4814 transcripts stratified myometrial samples into quiescent (Q) and nonquiescent (NQ) phenotypes, independent of gestational age and incision site. Similar stratifications were achieved using expressed genes in Ca2+ signaling and TGF-β pathways. For maximal parsimony, we evaluated the expression of just 2 Ca2+ transporter genes, ATP2B4 (encoding PMCA4) and ATP2A2 (coding for SERCA2), and we found that their ratio reliably distinguished NQ and Q specimens in the current study, and also in 2 publicly available RNA-seq data sets (GSE50599 and GSE80172), with an overall AUC of 0.94. Cross-validation of the ATP2B4/ATP2A2 ratio by quantitative PCR in an expanded cohort (by 11 additional specimens) achieved complete separation (AUC of 1.00) of NQ versus Q specimens. While providing additional insight into the associations between clinical features of term and preterm labor and myometrial gene expression, our study also offers a practical algorithm for unbiased classification of myometrial biopsies by their overall contractile program.

Differential Expression Changes in Human Decidua With Term and Preterm Labor: Role for Upstream Targets in the Prostaglandin Pathway

Introduction: Prostaglandins (PGs) are paracrine mediators thought to be important during pregnancy and labor. Synthesis of PGs is complex with three rate limiting steps, the second of which (PTGS2/cyclooxygenase) is a target for managing preterm labor, but this treatment is not always effective. It is suggested that alternate steps in the PG pathway may play distinct roles during labor and hence the potential as alternate targets for labor management. The first step of PG synthesis involves the action of phospholipase A2 (PLA2) enzymes, of which over a dozen isotypes are known. However, PLA2 expression and role in the decidua (maternal-fetal interface) is unknown. We hypothesize that distinct PLA2 isotypes are present within the decidua and play a role in term and preterm labor. To this end, we conducted an expression profile of PLA2 subtypes and related PG genes within human decidua and determined differential expression patterns with labor at term and preterm. Methods: Decidual samples from term (40wks) and preterm (26-37wks) Cesarean deliveries, were used to assess PG gene expression by RNAseq and qRT-PCR (n=7 preterm non-labor, n=11 preterm labor, n=31 term non-labor, n=31 term labor). Analyses were conducted using student’s t-test and one-way ANOVA to compare labor (non-labor vs labor) or with gestation (preterm vs term) and adjusted for multiple testing using the Benjamini-Hochberg method. Results: RNAseq analysis identified 30 highly expressed PG genes in decidua, of which 12 had not been previously reported in the uterus, including 7 PLA2 isotypes. Confirming previous work, expression of PTGS2 was higher with labor (p=0.011). In contrast, we demonstrate that PLA2 isotype expression is lower with labor, with further differences between term and preterm samples. With term labor, expression of PLA2 isotype 2D was lower compared to non-labour (p=0.047). Meanwhile, preterm labor was associated with lower expression of PLA2 isotype 16 (p=0.025) and 4C (p=0.026), compared to preterm non-labour. Epression of PLA2 subtypes 2A, 15 and 4A late was highest in late labor (p=0.016, 0.004, 0.03, respectively). Conclusion: The presence of multiple PLA2 subtypes within the decidua suggests the potential for fine tuning PG synthesis during pregnancy. Expression of PLA2 isotypes 16 and 4C was uniquely associated with preterm labor, suggesting these isotypes may play a role in the pathogenesis of preterm labor. Further investigation of the functional role of PLA2 isotypes may provide insight to a novel mechanism for preterm labor and identify potential targets for labor management.

Slowing of fetal growth and elevated maternal serum sFLT1:PlGF are associated with early term spontaneous labor

BackgroundThe physiological control of human parturition at term is unknown.ObjectiveThis study aimed to test the hypothesis that slowing of fetal growth or elevated maternal serum levels of markers of placental hypoxia in late gestation will be associated with earlier term labor.Study DesignWe observed 2208 women having first births and performed serial blinded ultrasonography and immunoassay of soluble fms-like tyrosine kinase-1 and placenta growth factor. We estimated the probability of spontaneous delivery from 37 weeks of gestational age concerning (1) fetal growth between 20 and 36 weeks of gestational age and (2) the maternal serum soluble fms-like tyrosine kinase-1–to–placenta growth factor ratio measured at approximately 36 weeks of gestational age. Data were analyzed using logistic regression and Cox regression.ResultsFetal size at 36 weeks of gestational age was not independently associated with the timing of delivery at term. However, there was an inverse relationship between fetal growth between 20 weeks of gestational age and 36 weeks of gestational age and the probability of spontaneous labor at 37 to 38 weeks’ gestation (hazard ratio [95% confidence interval] for a 50 percentile increase in abdominal circumference growth velocity, 0.60 [0.47–0.78]; P=.0001). This association was weaker at 39 to 40 weeks’ gestation (0.83 [0.74–0.93]; P=.0013), and there was no association at ≥41 weeks’ gestation. Very similar associations were observed for estimated fetal weight growth velocity. There was a positive relationship between soluble fms-like tyrosine kinase-1–to–placenta growth factor ratio and the probability of spontaneous labor at 37 to 38 weeks’ gestation (hazard ratio [95% confidence interval] for a 50 percentile increase in soluble fms-like tyrosine kinase-1–to–placenta growth factor ratio, 3.05 [2.32–4.02]; P<.0001). This association was weaker at 39 to 40 weeks’ gestation (1.46 [1.30–1.63]; P<.0001), and there was no association at ≥41 weeks’ gestation. Adjustment for maternal characteristics was without material effect on any of these associations.ConclusionSlowing of fetal growth and biomarkers of placental insufficiency were associated with an increased probability of early onset of spontaneous term labor. We speculated that progressive placental insufficiency may be a physiological phenomenon that occurs with advancing gestational age near and at term and promotes the initiation of labor.

Up-regulation of cytosolic prostaglandin E synthase in fetal-membrane and amniotic prostaglandin E2 accumulation in labor.

Prostaglandin E2 (PGE2) is known to have important roles in labor, but the detailed mechanism underlying the spontaneous human labor remains unknown. Here, we examined the involvement of prostaglandin biosynthetic enzymes and transporter in the accumulation of PGE2 in amniotic fluid in human labor. PGE2 and its metabolites were abundant in amniotic fluid in deliveries at term in labor (TLB), but not at term not in labor (TNL). In fetal-membrane Transwell assays, levels of PGE2 production in both maternal and fetal compartments were significantly higher in the TLB group than the TNL group. In fetal-membrane, the mRNA level of PTGES3, which encodes cytosolic prostaglandin E synthase (cPGES), was significantly higher in TLB than in TNL, but the mRNA levels of the other PGE2-synthase genes were not affected by labor. Moreover, the mRNA level of PTGS2, which encodes cyclooxygenase-2 (COX-2) in the amnion was significantly higher in TLB than in TNL. Western blot analyses revealed that the levels of COX-1 and COX-2 were comparable between the two groups, however, the level of cPGES was relatively higher in TLB than in TNL. COXs, cPGES, and prostaglandin transporter (SLCO2A1) proteins were all expressed in both chorionic trophoblasts and amniotic epithelium. These findings suggest that COXs, cPGES and SLCO2A1 contribute to PGE2 production from fetal-membrane in labor.

An Assessment of Abenomics from the Labor Market Perspective

The present paper documents the change in employment and wages between 2012 and 2020 when Prime Minister Shinzo Abe implemented his economic policy popularly known as Abenomics. Despite population aging that by itself would have decreased the employment rate by 2.8 percentage points, the aggregate employment rate increased from 56.5% in 2012 to 60.7% in 2019, largely because of a substantial increase in the 25–64‐year‐old female employment rate, which was especially profound in the health and welfare industry. The real wage declined by 1.8% from 2012 to 2017, of which 1.4% is explained by changes in worker composition, particularly the increase in female workers. We also assess the impact of COVID‐19 on the labor market in 2020 and discuss its impact on the long term labor market trend.

Case Report: 25-year-old Female at Term Labour and Normal Delivery

Labor has been defined as that of the initiation of periodic painful contractions of progressive deletion aswell as dilation of a cervix, followed by a decent part going to lead to the expulsion of its fetus &amp; placentafrom the uterus of mother. Post - natal treatment was its individualized treatment provided that meet theneeds of the baby and mother after delivery/childbirth.Case Report –Mrs. Nikita Matram 25-year-old female was admitted in AVBR Hospital with the complaintof pain in abdomen and increased the fetal movement on date 4/01/2020 and she delivered female baby ondate 6/01/2020 and the baby weight was 2.8 kg at 1:40 am now her complaint was pain on suture side andweakness. But the patient has a previous history of abortion after marriage of four month two and half monthof baby was abort. That time dilatation and curettage was done.Discussion – Patient delivered female baby throughout the vaginal delivery and baby and mother wasnormal after delivery baby was kept with mother on same bed and initiate breastfeeding within one hourafter delivery.Conclusion – Case report conclude that after normal delivery and post-natal care mother and baby wasnormal.