| Cervical ripening and insufficiency: from biochemical and molecular studies to in vivo clinical examination. | |
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MedLine Citation:
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PMID: 19303692 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To understand cervical ripening and especially the pathophysiology of cervical insufficiency, it is important to know the cervical composition: the cervix is dominated by fibrous connective tissue, consisting predominantly of Type I collagen (70%). Despite many studies of the cervix, we still rely upon relatively crude methods for clinical evaluation of the cervix. If the amount of cervical collagen plays a role in cervical insufficiency and in success of or length of induction of labor, then measurements of cervical collagen may provide an objective means of establishing the diagnosis or prognosis. We have established and reported a non-invasive means, called Collascope, to measure collagen cross-linking using light-induced fluorescence (LIF), and which is specifically designed to assess cervical ripening, and functions by measuring the natural fluorescence of non-soluble collagen in the cervix. Studies conducted in animals and humans in a variety of settings indicate that cervical function can be successfully monitored using the Collascope during pregnancy: LIF correlates negatively with gestational age and positively with time-to-delivery interval, and is predictive of delivery within 24h. Additionally LIF is significantly lower in women with cervical insufficiency. We suggest that the Collascope might be useful to better define management in cases of spontaneous preterm or induced term cervical ripening. From our studies and others, it is clear that in forecasting (pre-)term cervical ripening, the capability of the technologies and bioassays that have been generally accepted into clinical practice are limited. Any devices shown to be superior to the clinically accepted tests currently used should be quite useful for clinicians. The Collascope offers an objective measurement of both the function and state of the cervix, by directly measuring collagen cross-linking using LIF. |
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Authors:
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Dietmar Schlembach; Lynette Mackay; Leili Shi; William L Maner; Robert E Garfield; Holger Maul |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2009-03-20 |
Journal Detail:
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Title: European journal of obstetrics, gynecology, and reproductive biology Volume: 144 Suppl 1 ISSN: 1872-7654 ISO Abbreviation: Eur. J. Obstet. Gynecol. Reprod. Biol. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-10 Completed Date: 2009-07-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375672 Medline TA: Eur J Obstet Gynecol Reprod Biol Country: Ireland |
Other Details:
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Languages: eng Pagination: S70-6 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria. drschlembach@gmx.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cervical Ripening / physiology* Cervix Uteri / chemistry*, drug effects, physiology Collagen Type I / analysis* Diagnostic Techniques, Obstetrical and Gynecological* Female Fluorescence* Humans Pregnancy Premature Birth / diagnosis, prevention & control Prostaglandins / therapeutic use Spectrometry, Fluorescence / instrumentation Uterine Cervical Incompetence / diagnosis |
| Grant Support | |
ID/Acronym/Agency:
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7R01HD037480/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Collagen Type I; 0/Prostaglandins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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