Cervical effacement

Cervical effacement or cervical ripening refers to the thinning and shortening of the cervix. This process occurs during labor to prepare the cervix for dilation to allow the fetus to pass through the vagina. While this a normal, physiological process that occurs at the later end of pregnancy, it can also be induced through medications and procedures.^[2]

During gestation, the cervix maintains pregnancy by increasing synthesis of various proteins. These proteins have defined interactions that allow the formation of matrix proteins to help fortify the uterine cervix.^[3] Toward the end of pregnancy, a series of hormone-mediated biochemical process takes place to degrade the collagen and fiber network to cause the cervix to ripen during labor. Failure to ripen the cervix during labor may delay its onset and cause complications.^[4] Current efforts to induce labor include pharmacologic, non-pharmacologic, mechanical and surgical methods.

Cervical ripening has primarily been performed in the inpatient setting. Due to a variety of reasons, such as cost and patient preference, the capacity to undergo outpatient cervical ripening is being explored.^[5]