Cervical remodeling during pregnancy and parturition is a single progressive process that can be loosely divided into four overlapping phases termed softening, ripening, dilation/labor, and post partum repair. Elucidating the molecular mechanisms that facilitate all phases of cervical remodeling is critical for an understanding of parturition and for identifying processes that are misregulated in preterm labor, a significant cause of perinatal morbidity. In the present study, biomechanical measurements indicate that softening was initiated between gestation days 10 and 12 of mouse pregnancy, and in contrast to cervical ripening on day 18, the softened cervix maintains tissue strength. Although preceded by increased collagen solubility, cervical softening is not characterized by significant increases in cell proliferation, tissue hydration or changes in the distribution of inflammatory cells. Gene expression studies reveal a potentially important role of cervical epithelia during softening and ripening in maintenance of an immunomucosal barrier that protects the stromal compartment during matrix remodeling. Expression of two genes involved in repair and protection of the epithelial permeability barrier in the gut (trefoil factor 1) and skin (serine protease inhibitor Kazal type 5) were increased during softening and/or ripening. Another gene whose function remains to be elucidated, purkinje cell protein 4, declines in expression as remodeling progressed. Collectively, these results indicate that cervical softening during pregnancy is a unique phase of the tissue remodeling process characterized by increased collagen solubility, maintenance of tissue strength, and upregulation of genes involved in mucosal protection.

Oral communication abstracts consensus by the ultrasound readers and MR readers, respectively. Consensus was significantly more likely when VM was isolated than when other anomalies were present (P < 0.0001). There were 80 cases (153 disagreements) and 94 cases (223 disagreements) without consensus on the ultrasound and MR readings, respectively. There were 30 and 29 disagreements on ultrasound and MR regarding major findings either being present or absent. There was no effect on agreement when comparing cases with consensus/decision to call VM, or no clinical difference due to disagreements vs. all other disagreements with respect to BPD, HC, GA by ultrasound or GA by dates. There was a significant difference in these groups when comparing ventricular size; fetuses with larger ventricles were more likely to have clinically important disagreements. Comparing the prospective seven readings, there were 83/196 (42%) cases with complete agreement. Comparing the consensus ultrasound opinion to the consensus MR opinion there were 135/196 (69%) cases with complete agreement. There were 32/196 (16%) cases of diagnosis disagreement. Conclusions: Disagreements regarding major findings on prenatal ultrasound and MR are common in fetuses with VM. Individual training may contribute to these disagreements. This variability should be taken into account when counseling patients with fetuses with VM.

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We recently performed an autopsy on a premature female newborn with rhizomesoacromelic limb shortening of the upper and lower extremities, craniofacial dysmorphism, and chondrodysplasia punctata. A diagnosis of Conradi-Hunermann-Happle syndrome or X-linked dominant chondrodysplasia punctata was made based on elevated cholest-8(9)-ene-3beta-ol in serum and tissues. Molecular analysis of EBP, mutations of which are responsible for this malformation syndrome, revealed a monoallelic missense mutation, c.328 G>A (R110Q). We present this case as an illustration of an unusually severe manifestation of this disorder in a female, with additional unusual features including lack of skin manifestations and apparent bilateral symmetry of the skeletal findings.

polyps, submucosal fibroids, or adhesions were studied. Removed tissue was examined with both standard and vessel staining to determine the presence of vessels greater than 0.5 mm and microvessel density. Results: Of the 25 patients examined (as of September 2002), 21 had abnormal endometrial (18) or myometrial lesions (3). Three had clots that were avascular. Endometrial lesions consisted of 17 polyps, whereas all myometrial lesions were submucoal fibroids. The number of vessels seen in polyps ranged from 1 to 8, whereas fibroids tended to have more (4 -9) vessels. Myometrial lesions tended to have vessels that arose deeper from the middle layer of myometrial when compared to polyps the vessels of which originated from the endometrial or spiral vessels. Microvessel density ranged from 6/h.p.f. to 120/h.p.f. Conclusions: Color Doppler sonohysterography showed a range of vascularity and may be useful in the distinction of polyps from intracavitary submucosal fibroids.