Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 207, Issue 5, Pages 345-354Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2012.05.015
Keywords
microstructural assessment; preterm birth; quantitative ultrasound measurement; short cervix
Categories
Funding
- National Institutes of Health from the Eunice Kennedy Shriver National Institute of Child Health and Human Development [R21HD061896, R21HD063031]
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Spontaneous preterm birth is a heterogeneous phenotype. A multitude of pathophysiologic pathways culminate in the final common denominator of cervical softening, shortening, and dilation that leads to preterm birth. A precise description of specific microstructural changes to the cervix is imperative if we are to identify the causative upstream molecular processes and resultant biomechanical events that are associated with each unique pathway. Currently, however, we have no reliable clinical tools for quantitative and objective evaluation, which likely contributes to the reason the singleton spontaneous preterm birth rate has not changed appreciably in >100 years. Fortunately, promising techniques to evaluate tissue hydration, collagen structure, and/or tissue elasticity are emerging. These will add to the body of knowledge about the cervix and facilitate the coordination of molecular studies and ultimately lead to novel approaches to preterm birth prediction and, finally, prevention.
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