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Histologically, the cervix undergoes significant changes towards the end of gestation, allowing the ripening of cervix for the passage of birth delivery. First, there is an increase in the cervical synthesis of glycosaminoglycan hyaluronan (HA), which increases tissue hydration, thereby catalyzing the degradation of collagen and elastin-fibers.
A ripe cervix is favorable prior to induction of labor, which is a common obstetric practice, and increases the chances for a successful induction. [24] Pharmacological methods are sometimes required to induce cervical ripening that does not occur naturally. [25]
Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing (starting) labor can be accomplished with pharmaceutical or non-pharmaceutical methods. In Western countries, it is estimated that one-quarter of pregnant women have their labor medically induced with drug treatment. [1]
Bishop score, also Bishop's score or cervix score, is a pre-labor scoring system to assist in predicting whether induction of labor will be required. [1] It has also been used to assess the likelihood of spontaneous preterm delivery. [ 2 ]
Cervical dilation may be induced mechanically by placing devices inside the cervix that will expand while in place. A balloon catheter may be used. Other products include osmotic dilators , such as laminaria stick (made of dried seaweed) or synthetic hygroscopic materials, which expand when placed in a moist environment.
Rankins says cervical insufficiency happens when there's painless dilation, or opening, of the cervix, typically in the second trimester of pregnancy, or during weeks 13 through 28.
In cases of cervical weakness, dilation and effacement of the cervix may occur without pain or uterine contractions. In a normal pregnancy, dilation and effacement occurs in response to uterine contractions. Cervical weakness becomes a problem when the cervix is pushed to open by the growing pressure in the uterus as pregnancy progresses.
Patients are typically offered testing if they have either a personal or family history of cancer that meets certain criteria, Zakalik adds. Those criteria have broadened over the last few years ...