Myometrial norepinephrine in human pregnancy. Elevated levels in various disorders leading to cesarean section.

Myometrial norepinephrine was measured consecutively with high-performance liquid chromatography in women who delivered by cesarean section. The previously recorded marked reduction in tissue norepinephrine at the end of normal pregnancy was confirmed. When cesarean section was performed because of abruptio placentae/hemorrhage, impending asphyxia, dystocia or preeclampsia, the norepinephrine concentrations were six to ten times higher than in normal pregnancy. When an emergency cesarean section was carried out for premature breech presentation, transverse position of the fetus or prolapse of the umbilical cord (following an otherwise-normal pregnancy), the reduced norepinephrine values were not significantly different from those measured in a control group of women who underwent elective cesarean section. It is possible that the abnormally elevated levels of myometrial norepinephrine are part of the primary pathophysiologic condition associated with sympathetic overactivity, resulting in disturbed myometrial circulation and/or motor activity.