The identification of causal factors for premature delivery in placenta and myometrium

delivery before 37 weeks of gestation is premature and with a prevalence of
9.6% this affects 14.000 newborns in the Netherlands each year. Prematurity is
the leading cause of neonatal mortality and morbidiy and strongly associated
with poor neurological and motor development during childhood.
premature delivery is usually the consequence of premature rupture of membranes
or premature labour. The growing fetaus, the placenta and the myometrium all
contribute to the initiation of delivery. The molecular process that initiates
delivery however, is not known, there are no prognostic markers available>
Treatment is usually only able to delay delivery for a short period of time, as
the onset of labour probably occurs weeks before actual labour starts. If
labour has started this process is already too far advanced to stop.
Detailed knowledge on the molecular events in placenta and myometrium that
initiate delivery, is essential to develop prognostic tests and rational and
effective treatment.

To obtain a durable biobank of placenta, placental bed and myometrium, combined
with a good clinical database. The tissue will be used to investigate
differences in tissue specific expression between woman who have not gone into
labour and deliver through primary caesarean section and women who deliver by
secondary caesarean section because of inadequate progression of labour.

This is an observational study. Pregnant women who undergo a caesarean section
will be asked to participate. The tissue samples collected will be udes to
investigate protein and mRNA expression profiles.

A myometrium biopsy is considered a standard procedure with minimal risk. The
duration of the procedure will be extented by a few minutes and the biopsy will
not contribute to bloodloss.