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SM ISO690:2012 CATRINICI, Rodica, FRIPTU, Valentin, CATRINICI, Larisa. Corelaţia oxidului nitric cu prostaglandina E2, progesteronul, estradiolul şi oxitocina în maturaţia colului uterin
. In: Analele Ştiinţifice ale USMF „N. Testemiţanu”, 2012, nr. 5(13), pp. 106-113. ISSN 1857-1719. |
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Analele Ştiinţifice ale USMF „N. Testemiţanu” | |||||
Numărul 5(13) / 2012 / ISSN 1857-1719 | |||||
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Pag. 106-113 | |||||
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Currently, the gold standard for induction of cervical ripening is considered local administration of PG. The effectiveness of preparing the cervix is estimated at 80-83%. However, their application act not only in the cervix, but can cause uterine hyperstimulation,with significant side effects for patients with scar uterus or fetal risk of respiratory distress, such as: placental abruption and fetal hypoxia. These complications in postmaturity pregnancies aggravate fetal status and increase the rate of obstetrical interventions, the perinatal and maternal mortality and morbidity. From this point of view, alternative methods for cervical ripening are needed, which would not impose these risks and NO donors in our opinion could be used successfully in such situations. NO participates in the maturation of the cervix by COX-2, metalloproteinases, glycosaminoglycans increasing and apoptosis. The local application of NO donors, in our case of Nitroglycerin, increase its concentration and lead to the development of this process. Postmaturity pregnancy evolves from a lack of NO local synthesis in the cervix, which together with PG E2, estradiol and oxytocin deficiency and the maintaining of progesterone block, lead to delays and/or disruption of the cervical ripening process and subsequently the onset of labor. |
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