diplomsko delo
Pia Pirnat (Author), Ana Polona Mivšek (Reviewer), Irina Milisav (Mentor), Mirjam Druškovič (Co-mentor)

Abstract

Uvod: Natančni molekularni mehanizmi uravnavanja poroda še danes niso povsem raziskani. Pomembno je poznavanje procesa normalnega in nenormalnega poroda, saj to pomaga pri razvijanju in uporabi novejših ter ustreznejših ukrepov za preprečevanje prezgodnjega poroda. Namen: Predstaviti in strniti že obstoječe, najnovejše in na dokazih temelječe znanje o molekularnih mehanizmih, ki sprožijo porod pri človeku. V nadaljevanju pa je namen opisati določene hormone oziroma dejavnike, ki so prisotni med porodom in glavne mehanizme, ki so odgovorni za prezgodnji porod. Metode dela: Uporabljena je bila deskriptivna ali opisna metoda dela s sistematičnim pregledom strokovne in znanstvene literature iz področja molekularnih mehanizmov uravnavanja poroda. Obstoječo znanstveno literaturo smo iskali s pomočjo podatkovnih baz CINAHL, MEDLINE, Pubmed, DiKUL in v kooperativnem bibliografskem sistemu COBISS.SI. Rezultati: Mehanizmi, ki vzdržujejo nosečnost in sprožijo začetek poroda, so zelo zapleteni in vključujejo mater, plod in njegove ovoje. Maternica in posteljica imata pomembno vlogo pri sintezi in sproščanju mediatorjev poroda. Končno skupno pot do poroda sestavljajo vnetne in endokrine interaktivne poti, ki vodijo v maternično krčenje in zorenje materničnega vratu. S kliničnimi raziskavami na živalih so znanstveniki dokazali, da plodova zveza/os hipotalamus-hipofiza-nadledvična žleza vpliva na čas začetka poroda. Dvig kortizola pri plodu neposredno vpliva na izražanje prostaglandin-E sintaza v posteljici, ki ima za posledico povečano delovanje prostaglandinov. Poleg tega so ostali mehanizmi, kot so padec progesterona in dvig estrogena, delovanje kortikoliberina, povečana občutljivost na oksitocin in nastanek presledkovnih stikov, ključ do uspešnega rojstva. Razprava in zaključek: Ključnega pomena pri razjasnjevanju mehanizmov poroda so raziskave na živalih in klinično opazovanje pri ljudeh. Do sedaj so znanstveniki ugotovili, da ti mehanizmi vključujejo plodove organe, ki so funkcionalno integrirani s posteljico in maternico. Na žalost pa v celoti ne vedo, kako natančnejši mehanizmi vplivajo na ciljna tkiva v maternici in materničnem vratu. Trenutno razumevanje mehanizmov ima pomemben vpliv na prepoznavanje znakov prezgodnjega poroda. Ker sta prezgodnji porod in porod po 40. tednu nosečnosti povezana s povečano perinatalno obolevnostjo, so v ta namen razvili klinične protokole za podaljšanje nosečnosti ali pravočasno indukcijo poroda.

Keywords

diplomska dela;babištvo;molekularni mehanizmi;uravnavanje poroda;hormoni;prezgodnji porod;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [P. Pirnat]
UDC: 618.2/.7
COBISS: 5757291 Link will open in a new window
Views: 637
Downloads: 190
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Other data

Secondary language: English
Secondary title: Molecular regulation of labour
Secondary abstract: Introduction: Accurate molecular mechanisms regulating labor, are not fully elucidated. Knowing both normal and abnormal labor is important for developing and use of advanced and more suitable measures for preventing preterm labor. Purpose: We wanted to present and condense most recent evidence based knowledge about molecular mechanisms, that trigger labor. We will describe specific hormones or factors present during labor and main mechanisms responsible for preterm labor. Methods: We used descriptive method with systematic overview of professional and scientific literature regarding molecular mechanisms regulating labor. Existing scientific literature was acquired through data bases CINAHL, MEDLINE, Pubmed, DiKUL and cooperative bibliographic system COBISS.SI. Results: Mechanisms, sustaining pregnancy and triggering labor, are very complex and include mother, fetus and its membranes. Uterus and placenta have an important role for synthesis and release of labor mediators. Final common pathway is composed by inflammatory and endocrine interactive paths, which lead uterine contractility and cervical dilatation. Clinical research showed that activation of fetal hypothalamic-pituitary-adrenal axis contributes to labor onset. Fetuses’ cortisol level increase affects PGHS expression in placenta, which consequently results in increased prostaglandin activity. Other mechanisms like in progesterone level decrease, estrogen level increase, CRH action, increased sensitivity to oxytocin and gap junction formation are key for successful birth. Discussion and conclusion: Animal research and clinical observation of humans are key for explanation of mechanisms. So far, scientists found out that these mechanisms include fetus’ organs, which are functionally integrated with placenta and uterus. Unfortunately, detailed mechanisms that affect target tissues in uterus and cervix are not discovered so far. Current mechanism understanding has important role in detecting preterm labor. Because of connection between the perinatal morbidity and preterm or post-term labor, scientists developed procedures to successfully prolong pregnancy or result in labor induction.
Secondary keywords: diploma theses;midwifery;molecular mechanisms;regulation of labour;hormones;preterm labour;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za babištvo
Pages: 40 str.
ID: 11347098