Dept. of OB/GYN, Columbia University Medical Center, New York, NY, USA.
Dept. of Mechanical Engineering, Columbia University, New York, NY, USA.
Best Pract Res Clin Obstet Gynaecol. 2018 Oct;52:88-102. doi: 10.1016/j.bpobgyn.2018.03.007. Epub 2018 Apr 11.
Spontaneous preterm birth (SPTB), defined as delivery before 37 weeks' gestation, remains a significant obstetric dilemma even after decades of research in this field. Although trends from 2007 to 2014 showed the rate of preterm birth slightly decreased, the CDC recently reported the rate of preterm birth has increased for two consecutive years since 2014. Currently, 1 in 10 pregnancies in the US still end prematurely. In this chapter, we focus on the "compartment" of the cervix. The goal is to outline the current knowledge of normal cervical structure and function in pregnancy and the current knowledge of how the cervix malfunctions lead to SPTB. We review the mechanisms by which our current interventions are hypothesized to work. Finally, we outline gaps in knowledge and future research directions that may lead to novel and effective interventions to prevent premature cervical failure and SPTB.
自发性早产 (SPTB) 是指妊娠不足 37 周的分娩，尽管该领域经过几十年的研究，但这仍然是一个重大的产科难题。尽管从 2007 年到 2014 年的趋势显示早产率略有下降，但疾病预防控制中心最近报告称，自 2014 年以来，早产率连续两年上升。目前，美国每 10 次妊娠中仍有 1 次提前结束。在本章中，我们重点关注宫颈的“部位”。我们的目标是概述正常妊娠时宫颈结构和功能的现有知识，以及宫颈功能障碍如何导致 SPTB 的现有知识。我们回顾了目前假设我们的干预措施发挥作用的机制。最后，我们概述了知识空白和未来的研究方向，这些可能会导致预防宫颈过早失效和 SPTB 的新的有效干预措施。
