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What does the anaesthetist need to know about uterotonics?.

Olga Cecilia Correa Chacón*

It is not possible to talk about the control of prophylactic uterotonic agents without talking about spontaneous labour at term, because labour includes neuroendocrine mechanisms. Also, immunological and inflammatory factors are part of the of this process - many of them based on synthesis of placental cortisol and prostaglandins. The thinning of the cervix (effacement), increased cervical dilation, and myometrial contractive activity have molecular and cellular regulations. The combination of elements like leukocytes, (T cells, macrophages, polymorphonuclear leukocytes) points to inflammatory reactions. In fact, at the onset of labour, there is overexposure to inflammatory cytokines. This is not a spontaneous process; an important role is played by two hormones and their receptors (RP): progesterone (PG), corticotropinreleasing hormone (CRH) and one protein associated with progesterone: NF- kB.