Annually, about 15 million preterm infants are born in the world. Of these, due to complications resulting from their premature birth, about 1 million would die before the age of five. Since the high incidence of preterm birth (PTB) is partially due to the lack of effective diagnostic modalities, methodologies are needed to determine risk of PTB. We propose a noninvasive tool based on polarized light imaging aimed at measuring the organization of collagen in the cervix. Cervical collagen has been shown to remodel with the approach of parturition. We used a full-field Mueller matrix polarimetric colposcope to assess and compare cervical collagen content and structure in nonpregnant and pregnant women in vivo. Local collagen directional azimuth was used and a total of eight cervices were imaged.
Preterm birth (PTB) presents a serious medical health concern throughout the world. There is a high incidence of PTB in both developed and developing countries ranging from 11% to 15%, respectively. Recent research has shown that cervical collagen orientation and distribution changes during pregnancy may be useful in predicting PTB. Polarization imaging is an effective means to measure optical anisotropy in birefringent materials, such as the cervix's extracellular matrix. Noninvasive, full-field Mueller matrix polarimetry (MMP) imaging methodologies, and optical coherence tomography (OCT) imaging were used to assess cervical collagen content and structure in nonpregnant porcine cervices. We demonstrate that the highly ordered structure of the nonpregnant porcine cervix can be observed with MMP. Furthermore, when utilized ex vivo, OCT and MMP yield very similar results with a mean error of 3.46% between the two modalities.
Adolescent pregnancy is an international dilemma affecting not just the adolescent and her infant, but entire societies. Of almost 300 million female adolescents worldwide, 16 million give birth yearly, accounting for 11% of all births worldwide. The Millennium Development Goal # 5 incorporates reducing adolescent births worldwide. The purpose of this paper is a comprehensive critique of findings on a global perspective on adolescent pregnancy and evaluation of strategies to reduce this international concern. In Latin America and the Caribbean, unmet need for family planning made little change in 20 years. In Dutch and Scandinavian countries, there are national sex education programmes and family planning clinics run by nurse midwives with direct authority to prescribe contraceptives. In Japan, strong conservative norms exist about premarital sex. In the UK, a lack of consistent targeted sex education, delay in access to contraception and contraceptive use failure are associated with high teen pregnancy rates. In the United States, 750,000 teen pregnancies occur yearly, costing $9 billion per year. Health disparities exist: Whites had 11, Blacks had 32 and Hispanics had 41 per 1000 births. Programmes to reduce teen pregnancy should incorporate family, contraception and abstinence education, and sustained commitment of media, businesses, religious and civic organizations.
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