<i>In vivo</i>
 assessment of the biomechanical properties of the uterine cervix in pregnancy

Mazza, Edoardo; Parra‐Saavedra, Miguel; Bajka, Michael; Gratacós, Eduard; Nicolaides, Kypros H.; Deprest, Jan

doi:10.1002/pd.4260

Cited by 54 publications

(47 citation statements)

References 61 publications

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“…The CCI is a reproducible measurement, although the force applied to the tissue is also unknown [28] . The quantitative measure is calculated as the ratio between the anteroposterior diameter at maximum compression and the diameter at rest [29] . The CCI has shown a clear inverse linear relationship with gestational age.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of the Cervical Texture by Ultrasound and Correlation with Gestational Age

Baños

Perez‐Moreno²,

Triginer³

et al. 2016

Fetal Diagn Ther

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Objectives: Quantitative texture analysis has been proposed to extract robust features from the ultrasound image to detect subtle changes in the textures of the images. The aim of this study was to evaluate the feasibility of quantitative cervical texture analysis to assess cervical tissue changes throughout pregnancy. Methods: This was a cross-sectional study including singleton pregnancies between 20.0 and 41.6 weeks of gestation from women who delivered at term. Cervical length was measured, and a selected region of interest in the cervix was delineated. A model to predict gestational age based on features extracted from cervical images was developed following three steps: data splitting, feature transformation, and regression model computation. Results: Seven hundred images, 30 per gestational week, were included for analysis. There was a strong correlation between the gestational age at which the images were obtained and the estimated gestational age by quantitative analysis of the cervical texture (R = 0.88). Discussion: This study provides evidence that quantitative analysis of cervical texture can extract features from cervical ultrasound images which correlate with gestational age. Further research is needed to evaluate its applicability as a biomarker of the risk of spontaneous preterm birth, as well as its role in cervical assessment in other clinical situations in which cervical evaluation might be relevant.

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Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of the Cervical Texture by Ultrasound and Correlation with Gestational Age

Baños

Perez‐Moreno²,

Triginer³

et al. 2016

Fetal Diagn Ther

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“…Furthermore, the cervical end of the uterus is assumed to be fixed in all directions. In reality the cervix is a compliant structure (Badir et al 2013;Mazza et al 2014;Briggs et al 2015;Myers et al 2015), and a more realistic, but still simple, boundary condition would be to assume a linearly elastic support. Numerical experiments using data from Badir et al (2013, Fig 11) indicate that the IUP remains relatively unchanged by this condition, but unphysiological oscillations in the displacement of the uterine wall led to the conclusion that this approach needs further work.…”

Section: Discussionmentioning

confidence: 98%

“…More experimental data would be useful to restrict the possible ranges of parameters in the model. This include geometrical data such as USM and collagen fibers architecture, which can be obtained noninvasively (Weiss et al 2006), and mechanical properties of the cervix (Badir et al 2013;Mazza et al 2014) for implementation of more realistic boundary conditions. A detailed statistical sensitivity analysis for the simulation is also desirable, possibly using response surface methodology (Myers et al 2009) as a way of reducing the amount of time spent on FE simulations.…”

Section: Discussionmentioning

confidence: 99%

Simulating uterine contraction by using an electro-chemo-mechanical model

Sharifimajd

Thore

Stålhand

2015

Biomech Model Mechanobiol

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Contractions of uterine smooth muscle cells consist of a chain of physiological processes. These contractions provide the required force to expel the fetus from the uterus. The inclusion of these physiological processes is, therefore, imperative when studying uterine contractions. In this study, an electro-chemo-mechanical model to replicate the excitation, activation, and contraction of uterine smooth muscle cells is developed. The presented modeling strategy enables efficient integration of knowledge about physiological processes at the cellular level to the organ level. The model is implemented in a three-dimensional finite element setting to simulate uterus contraction during labor in response to electrical discharges generated by pacemaker cells and propagated within the myometrium via gap junctions. Important clinical factors, such as uterine electrical activity and intrauterine pressure, are predicted using this simulation. The predictions are in agreement with clinically measured data reported in the literature. A parameter study is also carried out to investigate the impact of physiologically related parameters on the uterine contractility.

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“…The mechanical integrity of the tissue is in part attributable to the preferred directionality of its collagen fibers [3]. Mechanical properties of human cervical tissue have been previously measured using standard uni-axial compress/tension tests [4,5], indentation [6], permeability tests [7], and aspiration [8][9][10]. During pregnancy, the cervix becomes softer to accommodate delivery [9].…”

Section: Introductionmentioning

confidence: 99%

Analyzing three-dimensional ultrastructure of human cervical tissue using optical coherence tomography

Gan¹,

Wang²,

Myers³

et al. 2015

Biomed. Opt. Express

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During pregnancy, the uterine cervix is the mechanical barrier that prevents delivery of a fetus. The underlying cervical collagen ultrastructure, which influences the overall mechanical properties of the cervix, plays a role in maintaining a successful pregnancy until term. Yet, not much is known about this collagen ultrastructure in pregnant and nonpregnant human tissue. We used optical coherence tomography to investigate the directionality and dispersion of collagen fiber bundles in the human cervix. An image analysis tool has been developed, combining a stitching method with a fiber orientation measurement, to study axially sliced cervix samples. This tool was used to analyze the ultrastructure of exvivo pregnant and non-pregnant hysterectomy tissue samples taken at the internal os, which is the region of the cervix adjacent to the uterus. With this tool, directionality maps of collagen fiber bundles and dispersion of collagen fiber orientation were analyzed. It was found that that the overall preferred directionality of the collagen fibers for both the nonpregnant and pregnant samples were circling around the inner cervical canal. Pregnant samples showed greater dispersion than non-pregnant samples. Lastly, we observed regional differences in collagen fiber dispersion. Fibers closer to the inner canal showed more dispersion than the fibers on the radial edges.

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In vivo assessment of the biomechanical properties of the uterine cervix in pregnancy

Cited by 54 publications

References 61 publications

Quantitative Analysis of the Cervical Texture by Ultrasound and Correlation with Gestational Age

Quantitative Analysis of the Cervical Texture by Ultrasound and Correlation with Gestational Age

Simulating uterine contraction by using an electro-chemo-mechanical model

Analyzing three-dimensional ultrastructure of human cervical tissue using optical coherence tomography

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