Anatomy and Physiology of the Uterine Cervix

Ludmir, Jack; Sehdev, Harish M.

doi:10.1097/00003081-200009000-00003

Cited by 117 publications

(83 citation statements)

References 27 publications

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“…The human uterine cervix is a complex tissue composed of an extracellular matrix consisting predominantly of collagen with elastin and proteoglycans, and a cellular component consisting of smooth muscle and fibroblasts, epithelium, and blood vessels [9]. Hormone-regulated biochemical changes occur during pregnancy, ultimately leading to cervical ripening [10].…”

Section: Discussionmentioning

confidence: 99%

Frequency domain near‐infrared spectroscopy of the uterine cervix during cervical ripening

Baños

Wolf²,

Grawe

et al. 2007

Lasers Surg Med

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Objective: Preterm labor is a common obstetric complication. Clinical evaluation of cervical ripening to predict preterm labor has a substantial inter-and intraobserver variability. We used frequency domain near-infrared spectroscopy (FD-NIRS) to non-invasively investigate the changes of the optical properties (i.e., absorption and scattering of light) in the uterine cervix during druginduced cervical ripening. Methods: Ten volunteers scheduled for abortion were examined. Optical properties of the uterine cervix were measured and physiological parameters were calculated prior to and after induction of cervical ripening using topical misoprostol. Mean relative changes, standard error of the mean as well as statistical significance using the t-test were calculated for oxy-and deoxyhemoglobin, total hemoglobin, oxygen-saturation, and water. The wavelength-dependent decrease of scattering (scatter power) was calculated by an exponential fit and tested with the Wilcoxon test. Results: Misoprostol induced a decrease in total hemoglobin of 21+/-6% (P<0.05), a decrease in oxyhemoglobin of 22+/-6% (P<0.05), a decrease in deoxyhemoglobin of 16+/-11% and an increase of 368% (P<0.005) in water content. The scatter power was significantly lower (P<0.05) after cervical ripening. Conclusion: Our results show that FD-NIRS is a promising diagnostic tool to detect changes in cervical concentrations of hemoglobin and water. A severe tissue edema, probably due to a hormone-induced inflammatory process, seems to be important for cervical ripening. The reduction in total hemoglobin is likely to be a consequence of the increased water content of the tissue resulting in a dramatic increase of the distance between vessels. We propose this technology to assess the cervical ripening and eventually to predict preterm labor. Lasers Surg. Med. 39:641-646, 2007 Objective: Preterm labor is a common obstetric complication. Clinical evaluation of cervical ripening to predict preterm labor has a substantial inter-and intraobserver variability. We used frequency domain near-infrared spectroscopy (FD-NIRS) to non-invasively investigate the changes of the optical properties (i.e., absorption and scattering of light) in the uterine cervix during druginduced cervical ripening. Methods: Ten volunteers scheduled for abortion were examined. Optical properties of the uterine cervix were measured and physiological parameters were calculated prior to and after induction of cervical ripening using topical misoprostol. Mean relative changes, AE standard error of the mean as well as statistical significance using the t-test were calculated for oxy-and deoxyhemoglobin, total hemoglobin, oxygen-saturation, and water. The wavelength-dependent decrease of scattering (scatter power) was calculated by an exponential fit and tested with the Wilcoxon test.Results: Misoprostol induced a decrease in total hemoglobin of 21 AE 6% (P < 0.05), a decrease in oxyhemoglobin of 22 AE 6% (P < 0.05), a decrease in deoxyhemoglobin of 16 AE 11% and an increase of 36 AE 8%...

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Section: Discussionmentioning

confidence: 99%

Frequency domain near‐infrared spectroscopy of the uterine cervix during cervical ripening

Baños

Wolf²,

Grawe

et al. 2007

Lasers Surg Med

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“…Boundaries between these layers are not precisely defined. Quantity and quality of connective tissue vary throughout the corpus and cervix uteri (Rorie and Newton, 1967;Dubrausz et al, 1971;Leppert et al, 1986;Aspden, 1988;Leppert and Yu, 1991;Ludmir and Sehdev, 2000;Metaxa-Mariatou et al, 2002). The quantity of smooth muscle fibers diminishes from about 28% in the corpus to about 8% in the cervix (Schwalm and Dubrauszky, 1966).…”

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confidence: 99%

“…The human cervix uteri is composed predominantly of collagen and ground substance and contains relatively few smooth muscle cells (Danforth, 1947;Schwalm and Dubrauszky, 1966;Rorie and Newton, 1967;Ludmir and Sehdev, 2000). The muscle fiber architecture of the cervix uteri likewise consists of bundles running in an approximately circular fashion (Goerttler, 1929;Wetzstein, 1965), two fiber systems running at acute angles, and the continuation of the fibers of the parametrium (Lierse, 1960).…”

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confidence: 99%

Three‐dimensional fiber architecture of the nonpregnant human uterus determined ex vivo using magnetic resonance diffusion tensor imaging

et al. 2005

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The global muscle and collagen fiber orientation in the human uterus has been analyzed hitherto by various standard microscopic techniques. However, no widely accepted model of the fiber architecture of the myometrium could be acquired. The purpose of the present study was to investigate the uterus by magnetic resonance (MR) diffusion tensor imaging (DTI) in a 3D macroscopic approach. Ex vivo MR DTI measurements were performed on five uteri from nonpregnant patients. The main diffusion directions reflecting the orientation of directional structures in the examined tissues were determined from diffusion-weighted spin-echo measurements. A fiber tracking algorithm was used to extrapolate the fiber architecture. The method was validated against histological slides and indirectly through the analysis of leiomyomas, which exhibit less anisotropy than normal myometrium. Significant anisotropy was found in most regions of all examined nonpregnant human uteri. But only two systems of fibers were found running circularly along the intramural part of the uterine tubes. They merged caudally and built a close fitting envelope of circular layers around the uterine cavity. On the cervix, circular fibers were observed in the outer part as well as mostly longitudinal fibers in the inner part. These results confirm the existence of directional structures in the complex fiber architecture of the human uterus. They also indicate that MR DTI is a beneficial and complementary tool to standard microscopic techniques to determine the intrinsic fiber architecture in human organs.

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“…1 The cervical canal is 3cm in length extending from the internal os to the external os. The surrounding tissue components of cervical canal are fibrous, ground substance and cellular elements.…”

Section: Introductionmentioning

confidence: 99%

The Comparative Study of Drotaverine Hydrochloride vs Valethamate Bromide in Labor

Sunita¹,

Saritha²,

Hindumathi³

et al. 2015

jemds

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ABSTRACT:Child birth is one of the most important events in the life of a woman. Though it is a physiological event it is painful. The pain experienced is beyond description and is basically due to process of cervical dilatation. The duration of the first stage is longest of the 3 stages of labour and it is due to painful progressive cervical dilatation. It is ideal for any obstetrician to achieve reduction of pain and suffering during labour by accelerating the rate of cervical dilatation. INTRODUCTION:The cervix is a cylindrical fibro-muscular component of the lower end of the uterus measuring 3cm in length and 2cm in thickness. 1 The cervical canal is 3cm in length extending from the internal os to the external os. The surrounding tissue components of cervical canal are fibrous, ground substance and cellular elements. The distribution of muscular component is 29% in upper 1/3rd, 18% in the middle 1/3rd, 6% in lower 1/3rd i.e., maximum at the level of internal os offering maximum contractile response to the advancing foetal head following uterine contractions. 2 The fibrous component predominantly contains fibrils and collagen fibres arranged in the form of bundles and the elastin fibres which are in the form of sheets interspersed with in the collagen. The elastin fibres are capable of stretching and returning to its original size. The ground substance contains glycosaminoglycans like dermatan sulphate and hyaluronic acid, the proteoglycans like decorin and biglycan. The decorin-collagen interaction is responsible for orderly arrangement of the bundles of collagen. 3,4

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Anatomy and Physiology of the Uterine Cervix

Cited by 117 publications

References 27 publications

Frequency domain near‐infrared spectroscopy of the uterine cervix during cervical ripening

Frequency domain near‐infrared spectroscopy of the uterine cervix during cervical ripening

Three‐dimensional fiber architecture of the nonpregnant human uterus determined ex vivo using magnetic resonance diffusion tensor imaging

The Comparative Study of Drotaverine Hydrochloride vs Valethamate Bromide in Labor

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