Detection of Thyrotrophin Receptor in Human Myometrium

Study Overview
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Brief Summary
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It has been recognized for many decades that high thyrotrophin (TSH) levels in pregnant women are associated with poor obstetric outcome. Also, there is evidence that high TSH is related to fetal position at term, including breech which in turn is associated with obstetric complications. However, the mechanism behind remains to be elucidated. The current project is of basic-fundamental nature. It is used to better understand basis physiological processes. As in many other studies of similar basic nature, few numbers are always included. If a TSH receptor will be detected, future randomized controlled trials (RCT) might be worthwhile with large numbers of women who will be treated with thyroxine to possibly prevent abnormal fetal position during normal pregnancy. The aim of the current study is to evaluate whether a TSH receptor can be demonstrated in human myometrium. If so, the pathophysiology of high TSH in relation to obstetric outcome will become more clear. Furthermore, the aim is to test the myometrium in vitro for its relaxation and contractility and for the conductance of electropotentials.

Detailed Description
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It has been recognized for many decades that high thyrotrophin (TSH) levels in pregnant women are associated with poor obstetric outcome. Also, there is evidence that high TSH is related to fetal position at term, including breech which in turn is associated with obstetric complications. However, the mechanism behind remains to be elucidated. It has been shown that high TSH affects relaxation and contraction of the smooth muscle in large blood vessels in human. In animals, there is some evidence that TSH interferes with uterine contractility. Although a TSH receptor has been demonstrated outside the thyroid in bone, brain and heart, so far no research on a possible TSH receptor in human uterine tissue has been published. The current study is a pilot study in which in a limited number of participants (pregnant women, n=10) during elective Caesarean section a uterine specimen will be collected for analysis in a immune-laboratory. Another part of the specimen will be analysed in a technical laboratory(Technical University of Eindhoven)for analysing the relaxation and contractility of the myometrium and for studying the conductance of electropotentials.

Official Title
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Detection of Thyrotrophin Receptor in Human Myometrium

Conditions
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Thyrothrophin Receptor in Myometrium Tissue

Intervention / Treatment
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* Procedure: Myometrial biopsy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective caesarean section Term pregnancy > 37 weeks Age > 18 years Exclusion Criteria: Previous caesarean scar Gestational age < 37 weeks Maternal temperature > 37.8 degrees Celsius Meconium stained liquor Foetal distress Maternal diabetes Seropositivity Use of thyroid medication Maternal thyroid disease Age < 18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Elective caesarean section<br>Population: ten pregnant women, scheduled for elective caesarean section with a term pregnancy ( > 37 weeks). Inclusion criteria Elective caesarean section Term pregnancy > 37 weeks Age > 18 years Exclusion criteria Previous caesarean scar Gestational age < 37 weeks Maternal temperature > 37.8 degrees Celsius Meconium stained liquor Foetal distress Maternal diabetes Seropositivity Use of thyroid medication Maternal thyroid disease Age < 18 years | Procedure: Myometrial biopsy<br>* At caesarean section, after birth of the baby but before closure of the uterus, a biopsy from the upper lip of the incision in the lower uterine segment will be taken. This biopsy will measure approximately 2x50mm.<br>* Other names: Electropotentials;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Thyrothrophin receptor | Immunodetection of Thyrothrophin receptor in myometrium tissue | three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| electropotentials in myometrium and relaxation and contractility | Investigation of relaxation and contractility of myometrium. Conductance of electropotentials of myometrium tissue | Three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Thyrotrophin, Pregnancy, Human myometrium, Relaxation, Contractility