Monocytes at the crossroads of inflammation and labor: biomarker potential in prolonged deliveries - a narrative review.

Prolonged labor is a significant obstetric complication, often leading to adverse maternal and neonatal outcomes. Recent research has focused on the role of the immune system, particularly monocytes, in the pathophysiology of prolonged labor. Monocytes contribute to the inflammatory processes that govern cervical ripening, uterine contractility, and labor progression. However, dysregulation in monocyte activation and cytokine release can impair these processes, leading to labor complications. This review examines the role of monocytes as biomarkers in prolonged labor, emphasizing their involvement in immune response modulation and the potential for predicting labor outcomes. Monocytes are central to the inflammatory response during labor, where they are recruited to the cervix and uterus and release pro-inflammatory cytokines that facilitate cervical softening and uterine contractions. Changes in monocyte subsets and the cytokines they produce have been linked to both normal and pathological labor. Dysregulation in this immune response, characterized by either an overactive or underactive monocyte function, can result in prolonged labor. Identifying monocyte-derived biomarkers such as specific cytokine profiles and monocyte surface markers could offer valuable insights into the timing and progression of labor, helping to predict complications before they occur.