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Nguyen HP, Katta R

Normal purging peaks around weeks two through four and resolves by week six to eight

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Pathogenic overgrowth activates inflammatory (via TLR-mediated IL-1, TNF-, IL-6 overproduction) and oxidative stress pathways: pro-inflammatory cytokines promote cervical ripening, induce matrix metalloproteinases (MMPs) to degrade fetal membrane collagen, while reactive oxygen species (ROS) directly damage structural proteins, compromising membrane integrity

These products usually are manufactured abroad and sold illegally in the United States, often in shops catering to the Latino, Asian, African, or Middle Eastern communities