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Cervical ripening and preterm labor.


Cervical ripening that promotes preterm labor is distinct from what happens at the onset of normal-term labor, researchers have found. The findings challenge the conventional- premise that premature cervical ripening and remodeling are accelerated variations of term labor and that normal term ripening is caused primarily by an activation of inflammatory responses.

Cervical remodeling is the process by which the cervix is transformed to open sufficiently during birth.

Dr. Mala Mahendroo, Associate Professor of Obstetrics and Gynecology at the University of Texas, explains: "Premature cervical remodeling can occur by more than one mechanism and is not necessarily an acceleration of the physiologic process in term labor. Depending on the cause of preterm birth, that mechanism can vary."

The study has been selected by the Faculty of 1,000--an international group of more than 10,000 leading scientists and researchers--to be in its top 2 percent of published articles in biology and medicine.

Previous studies had suggested that in term and preterm labor, white blood cells flow into the cervix and release enzymes that break down tissue support and remodel the cervix, allowing a baby to pass through the birth canal. That is only half-right, researchers reported.

"The immune system or inflammatory response is sufficient to cause cervical ripening, but it's not absolutely necessary for it to happen," said Dr. Brenda Timmons, a research scientist in obstetrics and gynecology and co-lead author of the study.

Nearly 13 percent of all births in the United States are preterm. Premature infants can suffer respiratory distress, intraventricular hemorrhage, and even cerebral palsy. Identified risk factors for preterm birth include smoking, alcohol consumption, advanced maternal age, genetics, cervical insufficiency, previous preterm birth, and infection.

"In about half of all preterm births, the cause is unknown. It's critical to determine the multiple causes of preterm birth so that effective therapies can be developed for each kind," said Dr. Roxan'e Holt, a maternal-fetal medicine fellow and co-lead author of the study. "When patients present in preterm labor, we don't have a lot of therapy to stop the labor," she added.

(Source: Endocrinology, June 2011.)

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Publication:Nutrition Health Review
Geographic Code:1USA
Date:Jun 22, 2011
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