Cervical alterations in pregnancy

Best Pract Res Clin Obstet Gynaecol. 2018 Oct:52:88-102. doi: 10.1016/j.bpobgyn.2018.03.007. Epub 2018 Apr 11.

Abstract

Spontaneous preterm birth (SPTB), defined as delivery before 37 weeks' gestation, remains a significant obstetric dilemma even after decades of research in this field. Although trends from 2007 to 2014 showed the rate of preterm birth slightly decreased, the CDC recently reported the rate of preterm birth has increased for two consecutive years since 2014. Currently, 1 in 10 pregnancies in the US still end prematurely. In this chapter, we focus on the "compartment" of the cervix. The goal is to outline the current knowledge of normal cervical structure and function in pregnancy and the current knowledge of how the cervix malfunctions lead to SPTB. We review the mechanisms by which our current interventions are hypothesized to work. Finally, we outline gaps in knowledge and future research directions that may lead to novel and effective interventions to prevent premature cervical failure and SPTB.

Keywords: Cervix; Premature cervical remodeling; Preterm birth; Short cervix.

Publication types

  • Review

MeSH terms

  • Animals
  • Cerclage, Cervical
  • Cervix Uteri / diagnostic imaging
  • Cervix Uteri / physiology*
  • Cervix Uteri / physiopathology
  • Female
  • Humans
  • Pessaries
  • Pregnancy
  • Premature Birth / etiology
  • Premature Birth / prevention & control*
  • Progesterone / pharmacology
  • Progesterone / therapeutic use
  • Progestins / pharmacology
  • Progestins / therapeutic use
  • Risk Factors

Substances

  • Progestins
  • Progesterone