Uterine Excitability and Ion Channels and Their Changes with Gestation and Hormonal Environment

We address advances in the understanding of myometrial physiology, focusing on excitation and the effects of gestation on ion channels and their relevance to labor. This review moves through pioneering studies to exciting new findings. We begin with the myometrium and its myocytes and describe how excitation might initiate and spread in this myogenic smooth muscle. We then review each of the ion channels in the myometrium: L- and T-type Ca2+ channels, K-ATP (Kir6) channels, voltage-dependent K channels (Kv4, Kv7, and Kv11), twin-pore domain K channels (TASK, TREK), inward rectifier Kir7.1, Ca2+-activated K+ channels with large (KCNMA1, Slo1), small (KCNN1-3), and intermediate (KCNN4) conductance, Na-activated K channels (Slo2), voltage-gated (SCN) Na+ and Na+ leak channels, non-selective (NALCN) channels, the Na K-ATPase, and hyperpolarization activated cation channels. We finish by assessing how three key hormones-oxytocin, estrogen, and progesterone-modulate and integrate excitability throughout gestation.

Automated summary

This article reviews the advances in the understanding of myometrial physiology, focusing on excitation and the effects of gestation on ion channels. It discusses the role of various ion channels in myometrium, their modulation by key hormones, and their integration throughout gestation.