Human reproduction. Health, Medicine, Nursing Essay

CHILDBIRTH
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Childbirth
Labour is a physiological occurrence where the foetus gets out of the uterus. It entails uterine contractions that can be very painful which also increase in duration, intensity, and frequency resulting in progressive dilation and effacement of the cervix. In typical labour, there is a time-dependent link that influences the processes. The child initiates the process since they are bigger and are stretching and stressing the uterus (Han et al., 2018). This results in the production of cortisol and corticotropin-releasing hormone (CRH), which rises during the last few days.
The biochemical changes in the connective tissues of the cervix often start before uterine contractions sets in, which leads to cervical dilation (Peiris et al., 2017). The outcome is that the foetal membranes will rupture. Labour is the release from the inhibitory impacts of pregnancy on myometrium (Peiris et al., 2017). It is an event that entails the combination of complementary autocrine, paracrine, and endocrine variables that results in changes in the tissues of the uterus (deciduas, uterine cervix, and myometrium). Before parturition can occur, several changes arise in the reproductive tract. The uterus is first transformed from a quiescent structure that has dyssynchronous contractions to an active contracting organ that has complicated interlaced muscles that lead to consistent phasic contractions of the uterus (Peiris et al., 2017). This process is supported by the development of a gap junction that arises between the myometrial cells, which support the transmission of signals for contracting. The foetus will also influence the process via the production of steroid homes from the placenta, via secretion of neurohypophysis hormones, via uterine mechanical distention, and other prostaglandin synthesis stimulators.
The second changes occur in smooth muscles and connective tissues so that they can dilate and allow the foetus to go through the cervix. This is followed with a reduced levels of progesterone to increase in levels of estrogen, higher sensitivity to oxytocin via up-regulation of the receptors known as myometrial oxytocin, increased rate of formation of the myometrial gap junction, lower levels of nitric oxide activity and increased levels of calcium into myocytes (Itsukaichi et al., 2011). Other changes also include higher levels of PG synthesis in the uterus, and ATP dependent myosin increasing, and enlarged endothelin, which results in improved blood flow in the uterus and myometrial activity.
The final pathway before labour occurs foetal HPA axis activation. Changes also occur in the cervix, such as a reduction in progesterone dominance and actions of relaxin and prostaglandins, via connective tissue changes, collagenoylysis, and a reduction in the stabilization of collagen via metalloproteinase inhibitors, which result in cervical dilation and softening (Kota et al. 2013). The level of oxytocin and prostaglandin also rise, leading to the opening of the L-type calcium pathways as a response to depolarization. Oxytocin results in a steady rise in the dura...