Connective tissue changes in the cervix during normal pregnancy and pregnancy complicated by cervical incompetence.
When postpartum cervical biopsy specimens were compared with biopsy specimens from nonpregnant women, they revealed a 12-fold decrease in mechanical strength, a 50% reduction in the concentrations of collagen and sulfated glycosaminoglycans, a 35% reduction in hyaluronic acid, an increase in collagen extractability, and a fivefold increase in collagenolytic activity. Primiparas with relatively high concentrations of collagen and hyaluronic acid had relatively long cervical dilatation times during established labor, suggesting a physiologic importance to these variables. This correlation was not found in multiparas, even though the mean values of the biochemical parameters tested were similar to those in primiparas. Second-trimester biopsy specimens taken from patients with cervical incompetence contained normal collagen concentrations, but relatively high collagen extractabilities and collagenolytic activities, exceeding normal postpartum values. A biopsy specimen that was tested biomechanically had a very low strength and very high extensibility. Most likely, these data reflect a high turnover of collagen in incompetent cervices, resulting in a high proportion of newly synthesized collagen with low biomechanical strength.
Rechberger
T
T
Second Clinic of Operative Gynecology, Medical Academy of Lublin, Poland.
Uldbjerg
N
N
Oxlund
H
H
D000328:Adult; D001696:Biomechanical Phenomena; D002584:Cervix Uteri / Q000378:metabolism / Q000502:physiology* / Q000503:physiopathology; D003238:Connective Tissue / Q000378:metabolism / Q000502:physiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism; D006909:Hydroxyproline / Q000378:metabolism; D008875:Middle Aged; D009994:Osmolar Concentration; D011247:Pregnancy / Q000378:metabolism / Q000502:physiology*; D002581:Uterine Cervical Incompetence / Q000378:metabolism / Q000503:physiopathology*
D006820:Hyaluronic Acid; D006909:Hydroxyproline