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Uterine Contractility Patterns of the Outer and Inner Zones of the Myometrium

From the Department of Obstetrics and Gynecology, Maria-Middelares Clinic, Ghent, (B9000) Belgium

Abstract

In vitro studies of spontaneous motility and the effect of adrenaline and oxytocin were performed on sections of myometrium taken from different parts of nonpregnant and pregnant uteri. Six sections of myometrium from the same uterus were always investigated at the same time and under the same conditions. In nonpregnant uteri, sections of myometrium taken from the outermost part of the uterine wall showed strong regular contractions, stimulated by adrenaline but less so by oxytocin. This outer layer is wide at the fundus of the corpus uteri and narrow in the ishthmocervical region. Sections of myometrium taken from the innermost part of the uterine wall showed fewer spontaneous contractions, minimal response to adrenaline, and no response to oxytocin. This inner layer is narrow at the fundus of the corpus and wide in the isthmocervical region. In the postpartum uterus, sections of myometrium from the outer layer showed regular spontaneous contractions with a higher amplitude than in the nonpregnant uterus; these were slightly depressed by adrenaline and strongly reinforced by oxytocin. Sections of myometrium from the inner layer of the postpartum uterus showed a spontaneous motility, more strongly pronounced than in the nonpregnant uterus. Contractions were little affected by oxytocin, although under the influence of adrenaline a strong and continuous tonic contraction occurred. From the functional point of view, the existence of two different zones in the myometrium can be related to the embryologic origin of the uterus. The existence of an outer and an inner zone with different contractile characteristics and different reactions to adrenaline and oxytocin throws new light on the physiology of labor and the postpartum period.

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