Some Molecular Mechanisms of Cervical Ripening

Abstract

Cervical remodeling is an active dynamic process that begins long before the onset of labor. The optimal course of the cervical ripening/remodeling processes is a prerequisite for successful vaginal delivery. Cervical remodeling is a slow progressive process that begins early in mammalian pregnancies, and can be loosely divided into four overlapping phases termed softening, ripening, dilation/labor, and postpartum repair. This review discusses some aspects of structural changes in the cervix at different stages of cervical ripening. In particular, the role of cervical epithelia, immune-inflammatory factors/cells, and components of the cervical extracellular matrix in cervical ripening is considered. A better understanding of the molecular-biochemical and histophysiological processes occurring during cervical remodeling is critical for the development of novel approaches to treat cervical insufficiency, preterm labor, and postpartum cervical disorders associated with its integrity.