About preterm birth

Preterm birth (PTB) is a syndrome and not a disease. Many pathological mechanisms can trigger acceleration of the process of cervical ripening in normal birth, resulting in premature birth.

As a team of scientists and clinicians at UCSF devoted to addressing preterm birth, we hypothesize that many of the causes of preterm birth are reversible if microscopic cervical ripening processes could be detected earlier. This would open a new therapeutic window in which clinicians may be able to diagnose the underlying cause (e.g., malaria in developing countries) and reverse the underlying process driving preterm birth (e.g., antibiotics). Infants lucky to survive a premature birth often still battle developmental and lifelong disabilities.

The pregnant cervix

At the beginning of pregnancy, the cervix is comprised of firm connective tissue and acts as a closed gate between the uterus and the vaginal canal. Throughout pregnancy, a process called cervical ripening causes changes in the tissue microstructure to enable the cervix to soften, shorten, and eventually dilate and efface away during labor. It is thought that preterm birth is the result of mechanisms causing the opening of this gate too early or quickly.

Current care strategies

Monitoring for preterm birth is currently performed only on high-risk pregnant women using transvaginal ultrasound to measure the length of the cervix. Short cervical length indicates preterm birth risk. However, the sensitivity and specificity of cervical length ultrasound is limited and subject to high operator and patient variability. Furthermore ultrasound technology is not available in many developing nations where preterm birth is highly prevalent.

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