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Chapter 13 - Normal Labor and Delivery

267 Chapter 13 Normal Labor and DeliverySarah Kilpatrick and Etoi GarrisonLABOR: DEFINITION AND PHYSIOLOGYL abor is defined as the process by which the fetus is expelled from the uterus. More specifically, Labor requires regular, effective contractions that lead to dilation and effacement of the cervix. This Chapter describes the physiology and Normal characteristics of term Labor and physiology of Labor initiation has not been com-pletely elucidated, but the putative mechanisms have been well reviewed by Liao and Labor initia-tion is species-specific, and the mechanisms in human Labor are unique. The four phases of Labor from quiescence to involution are outlined in Figure The first phase is quiescence and represents that time in utero before Labor begins when uterine activity is suppressed by the action of progesterone, prostacyclin, relaxin, nitric oxide , parathyroid hormone related peptide, and possibly other hormones.

action of progesterone, prostacyclin, relaxin, nitric oxide, parathyroid hormone–related peptide, and possibly other hormones. During the activation phase, estrogen begins to facilitate expression of myometrial receptors for prosta-glandins (PGs) and oxytocin, which results in ion channel activation and increased gap junctions.

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