Cervical ripening more than accelerates.

• Position: Preterm Labor

Cervical ripening that instigates preterm labor is distinct from what happens at the onset of normal term labor, researchers at the University of Texas Southwestern Medical Center, Dallas, have found. This challenges the conventional premise that premature cervical ripening and remodeling likely is just an accelerated version of the term labor process, and that normal term ripening is caused primarily by activation of inflammatory responses. Cervical remodeling is the process by which the cervix is transformed to open sufficiently during the birth process.

"Premature cervical remodeling can occur by more than one mechanism and is not necessarily an acceleration of the physiological process in term labor. Depending on the cause of preterm birth, that mechanism may vary," explains Mala Mahendroo, associate professor of obstetrics and gynecology.

Previous studies suggest that, in term or preterm labor, white blood cells influx 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 in this investigation report. "The immune system or...