Department of Obstetrics and Gynecology, Ordine dei Medici della Provincia di Pavia, Pavia, Italy
Research Article
Diagnosis of Labor and Human Evolution: Why Is It so Difficult to Diagnose Labor in Humans? The Contribution of Metabolomics.
Author(s): Antonio Ragusa*, Maria Matta, Denise Rinaldo and Alessandra Meloni
The difficulty in the clinical diagnosis of labor is due to an evolutionary mismatch. The ability to hide the signs and
symptoms of labor is an evolutionary trait that was once advantageous, but became abnormal due to environmental
changes. Prospective diagnosis of labor is not possible with certainty using only clinical criteria; however, by analyzing
the urinary metabolome of women in labor, this diagnosis is likely possible in all cases. In this review, we explain
why the two methods (clinical and metabolomic) differ in efficacy and sensitivity, and we try to fit this difference
into an evolutionary framework that explains these discrepancies considering evolutionary mismatch. The study
of metabolomics allows the truth to emerge from the past, and the diffusion of metabolomic techniques and their
application to clinical reality in the form of POC (Point of Care.. View more»