The initiation of labour at term gestation: physiology and practice implications

Little is known about the physiology of labour onset at term, and there is a debate about what signs and symptoms should be used to define it. In low resource settings and, particularly, for remote and rural communities, delay in recognising labour onset may mean a delay in seeking a skilled birth attendant. This chapter presents the most recent evidence about the physiology of labour onset, including the complex neuro-hormonal, biophysical, psychological and emotional factors that contribute. The symptoms of labour onset are explored from the perspective of both pregnant women and service providers in a range of sociocultural contexts. Early labour presents challenges for pregnant women, their families, communities and health care professionals. The chapter discusses how maternity care services should be designed, and delivered to ensure that women get the optimum advice and care at the beginning of labour

Supplementation with exogenous coenzyme Q10 to media for in vitro maturation and embryo culture fails to promote the developmental competence of porcine embryos

The coenzyme Q10 (CoQ10) is a potent antioxidant with critical protection role against cell oxidative stress, caused by the mitochondrial dysfunction. This study evaluated the effects of CoQ10 supplementation to in vitro maturation (IVM) or embryo culture media on the maturation, fertilization and subsequent embryonic development of pig oocytes and embryos. Maturation (Experiment 1) or embryo culture (Experiment 2) media were supplemented with 0 (control), 10, 25, 50 and 100 μM CoQ10. The addition of 10–50 μM CoQ10 to the IVM medium did not affect the percentage of MII oocytes nor the fertilization or the parameters of subsequent embryonic development. Exogenous CoQ10 in the culture medium neither did affect the development to the 2–4‐cell stage nor rates of blastocyst formation. Moreover, the highest concentration of CoQ10 (100 μM) in the maturation medium negatively affected blastocyst rates. In conclusion, exogenous CoQ10 supplementation of maturation or embryo culture media failed to improve the outcomes of our in vitro embryo production system and its use as an exogenous antioxidant should not be encouraged.We thank the Seneca Foundation, Murcia, Spain (Saavedra Fajardo Program; 20027/SF/16), and the Junta de Comunidades de Castilla‐La Mancha, Spain (PRT program; SBPLY/17/180501/000500), for co‐funding support of C Maside and the Ministry of Economy and Competitiveness (Madrid, Spain) for its grant‐based support of CA Martinez and JM Cambra (BES‐2013‐064087 and BES‐2016‐077869, respectively). This study was supported by MINECO‐FEDER (AGL2015‐69735‐R), Madrid, Spain, Seneca Foundation (19892/GERM/15), Murcia, Spain, and the Research Council FORMAS, Stockholm (Project 2017‐00946).Peer reviewe