12/18/2023 0 Comments Losing mucus plug at 38 weeks![]() ![]() Given the role of cervical mucus as a selectively permeable barrier, its location between the colonized vagina and the sterile uterine cavity, and the strong association between intrauterine infection and preterm birth, we sought to examine changes in the barrier properties of cervical mucus in women at high and low-risk for preterm birth. (B) Diagram of the cervical mucus plug in situ. (A) MRI image of patient at 34 weeks gestation.Īrrow points to cervical mucus plug. However, a detailed understanding of the barrier properties of cervical mucus is not understood. The cervical mucus plug in normal pregnancy has properties of both innate and adaptive immunity –, and is, therefore, thought to play a vital protective role during pregnancy. Cervical mucus is secreted from goblet cells within crypts lining the cervical canal, and, during pregnancy, condenses to form a large compact structure commonly known as the “cervical mucus plug” that is shed prior to delivery. ![]() The mucus barrier functions to both shield the underlying epithelia from infectious agents and other environmental particles/pathogens while allowing selective passage to nutrients, ions, gases, proteins and sperm. Its main gel-forming constituents are the mucin glycoproteins, which entangle to form a viscoelastic hydrogel. ![]() The cervical canal is filled with mucus, a ubiquitous hydrogel that lines all wet surfaces in the body including the respiratory and gastrointestinal tracts. A short cervix, as measured by transvaginal ultrasound, is a strong predictor of subsequent preterm birth, and is typically followed by treatment strategies such as progesterone supplementation or cerclage placement –. The main path of infection for vaginal microbes is the cervical canal, the main physical barrier that separates the vaginal tract from the sterile intrauterine cavity ( Figure 1). However, the barrier mechanisms preventing ascending intrauterine infection are poorly understood. Taken together, these studies suggest that intrauterine infection occurs because the barrier to ascending infection is impaired. In addition to infection, preterm birth is also associated with a robust inflammatory response in the amniotic fluid and cervical mucus. ![]() Common vaginal organisms, including genital ureaplasmas and mycoplasmas as well as gram positive and gram negative bacteria, are commonly found in amniotic fluid cultures of preterm birth patients. The pathophysiology most commonly linked to preterm birth is bacterial invasion from the colonized vagina to the sterile uterine cavity –. Preterm infants that survive the newborn period are at increased risk for long-term health complications including neurodevelopmental disability, decreased growth, chronic lung disease and cardiovascular morbidity –. Preterm birth is the leading cause of newborn mortality–more than half of all infant deaths in the United States occur to infants born prior to 32 weeks gestation. Preterm birth, or birth prior to 37 weeks of gestation, affects over 12% of pregnancies in the United States and leads to $26 billion in annual healthcare costs. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |