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Cervical Ripening: Biochemical, Molecular, and Clinical Considerations

MAUL, HOLGER MD, MMSc*; MACKAY, LYNETTE BS; GARFIELD, ROBERT E. PhD

Clinical Obstetrics & Gynecology: September 2006 - Volume 49 - Issue 3 - pp 551-563
Symposium on Cervical Ripening and Labor Induction

The physiologic and pathologic changes of the uterine cervix during pregnancy leading to cervical ripening are not well understood though are related to the chief pathology and a commonly performed intervention in obstetrics: Preterm birth and labor induction. Normal cervical ripening is thought to be controlled by a variety of hormonal changes occurring during pregnancy leading to softening and dilation. Abnormal premature ripening, usually resulting in preterm labor, is thought to be associated with infection and inflammatory events. Despite many studies of the cervix, we still rely upon relatively crude methods for clinical evaluation of the cervix. In the past several years, we have developed and evaluated a method to measure cervical collagen noninvasively using an instrument called Collascope. Studies in animals and humans conducted in a variety of settings indicate that cervical function can be successfully monitored using the Collascope during pregnancy. We suggest that this technique might be useful to better define management in cases of spontaneous preterm and induced term cervical ripening.

*Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany

University of Texas Medical Branch, 301 University, Department of Obstetrics and Gynecology, Division of Reproductive Sciences, Galveston, Texas

Correspondence: Robert E. Garfield, PhD, Professor, Director of the Division of Reproductive Sciences, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX 77555-1062. E-mail: rgarfiel@utmb.edu

© 2006 Lippincott Williams & Wilkins, Inc.