Endocrinology of human parturition

Human pregnancy maintenance and parturition involve complex interactions among mother, fetus, and placenta.

• The transition to delivery includes a shift from progesterone to estrogen dominance.
• Increased sensitivity to oxytocin and the formation of gap junctions are critical for uterine contractility.
• Cervical changes are marked by decreased progesterone dominance and increased activity of prostaglandins and relaxin, leading to softening and dilation.
• Neuronal, hormonal, inflammatory, and immune pathways are involved in labor initiation.
• The utero-placental unit plays a significant role in producing and releasing mediators that trigger parturition.

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