Mechanical and biochemical properties of human cervical tissue

Myers, Kristin M.; Paskaleva, Anastassia; House, Michael; Socrate, Simona

doi:10.1016/j.actbio.2007.04.009

Cited by 178 publications

(217 citation statements)

References 43 publications

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“…13,[18][19][20][21][22][23][24][25][26][27] This series of events needs to occur to allow eventual vaginal delivery of a fetus, but premature changes and/or underlying abnormal cervical microstructure may result in preterm birth. 28 Paramount to solving the problem of preterm birth is targeted and thorough evaluation of the cervix, and this is our motivation for developing quantitative ultrasound (QUS) methods for in vivo study of cervical collagen microstructure. Our choice of QUS methods is based on the assumption that collagen is the dominant source of acoustic scattering in cervical tissue, as it is for many tissues.…”

Section: Introductionmentioning

confidence: 99%

Nonlinear optical microscopy and ultrasound imaging of human cervical structure

et al. 2013

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Abstract. The cervix softens and shortens as its collagen microstructure rearranges in preparation for birth, but premature change may lead to premature birth. The global preterm birth rate has not decreased despite decades of research, likely because cervical microstructure is poorly understood. Our group has developed a multilevel approach to evaluating the human cervix. We are developing quantitative ultrasound (QUS) techniques for noninvasive interrogation of cervical microstructure and corroborating those results with high-resolution images of microstructure from second harmonic generation imaging (SHG) microscopy. We obtain ultrasound measurements from hysterectomy specimens, prepare the tissue for SHG, and stitch together several hundred images to create a comprehensive view of large areas of cervix. The images are analyzed for collagen orientation and alignment with curvelet transform, and registered with QUS data, facilitating multiscale analysis in which the micron-scale SHG images and millimeter-scale ultrasound data interpretation inform each other. This novel combination of modalities allows comprehensive characterization of cervical microstructure in high resolution. Through a detailed comparative study, we demonstrate that SHG imaging both corroborates the quantitative ultrasound measurements and provides further insight. Ultimately, a comprehensive understanding of specific microstructural cervical change in pregnancy should lead to novel approaches to the prevention of preterm birth.

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Section: Introductionmentioning

confidence: 99%

Nonlinear optical microscopy and ultrasound imaging of human cervical structure

et al. 2013

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“…1͑a͒. 3,[5][6][7] Current evidence suggests that changes in the extracellular matrix of the cervix underlie the progressive changes in cervical compliance and that these processes are well conserved between human and mouse. [8][9][10] These changes involve the alteration of fibrillar collagen assembly, its processing, and changes in the composition of other ECM components within the cervix, such as proteoglycans and glycosaminoglycans.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 Similarly in humans, increases in collagen solubility correlate with an increase in cervical malleability preceding birth. 7,[15][16][17][18][19][20] Women with defects in genes involved in collagen assembly or metabolism have a greater incidence of preterm birth due to cervical insufficiency. 21 Despite numerous reports suggesting there is a decline in cervical collagen concentration prior to birth, recent studies report no decrease in collagen content, further highlighting the importance of changes in other properties of the collagen matrix.…”

Section: Introductionmentioning

confidence: 99%

Second harmonic generation imaging as a potential tool for staging pregnancy and predicting preterm birth

2010

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Abstract. We use second harmonic generation ͑SHG͒ microscopy to assess changes in collagen structure of murine cervix during cervical remodeling of normal pregnancy and in a preterm birth model. Visual inspection of SHG images revealed substantial changes in collagen morphology throughout normal gestation. SHG images collected in both the forward and backward directions were analyzed quantitatively for changes in overall mean intensity, forward to backward intensity ratio, collagen fiber size, and porosity. Changes in mean SHG intensity and intensity ratio take place in early pregnancy, suggesting that submicroscopic changes in collagen fibril size and arrangement occur before macroscopic changes become evident. Fiber size progressively increased from early to late pregnancy, while pores between collagen fibers became larger and farther apart. Analysis of collagen features in premature cervical remodeling show that changes in collagen structure are dissimilar from normal remodeling. The ability to quantify multiple morphological features of collagen that characterize normal cervical remodeling and distinguish abnormal remodeling in preterm birth models supports future studies aimed at development of SHG endoscopic devices for clinical assessment of collagen changes during pregnancy in women and for predicting risk of preterm labor which occurs in 12.5% of all pregnancies.

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“…15 In previous work, we explored relationships between cervical mechanical properties 16,17 and biochemical constituents 18 in an effort to define the biochemical basis of cer- The cervix appears to change its shape, although the cervical length is maintained. Between the second and third trimesters, there is apparent anterior translation of the internal os.…”

Section: Discussionmentioning

confidence: 99%

A Method to Visualize 3-Dimensional Anatomic Changes in the Cervix During Pregnancy

Iams

Tangchitnob

Socrate

et al. 2010

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to develop a method to visualize 3-dimensional (3D) anatomic changes in the cervix and lower uterine segment during the antepartum period. Methods. An observational study of patients with both uncomplicated and complicated pregnancies was performed. To visualize 3D anatomic changes, solid models were constructed from 3D sonographic data. Model construction followed a 3-step protocol. First, 3D transvaginal sonographic data of the cervix and lower uterine segment were obtained. Second, sonographic data were exported to a medical image-processing program, which was used to align 3D sonographic data obtained from a single patient at different time points. Last, sonographic data were used to guide construction of solid models using mechanical design software. Anatomic changes were visualized by comparing solid models constructed from sonographic data obtained at different time points. Results. From 16 patients who consented, 5 patients were selected for this study. Two to 4 models were derived from each of the 5 patients at 15 to 38 weeks' gestation. To show anatomic changes in the cervix and lower uterine segment, solid models from different time points in the same patient were superimposed. A total of 16 solid models were constructed. In addition, 3D changes associated with second-trimester cervical failure and successful therapeutic cerclage were shown. Conclusions. A method to visualize 3D cervical changes is presented, revealing complex anatomic changes in the lower uterine segment, cervical stroma, and cervical mucosa as pregnancy progresses. Key words: cervical ripening; cervix; 3-dimensional sonography.Received July 20, 2009, Maternal-Fetal Medicine Annual Meeting; January 26-31, 2009; San Diego, California. Address correspondence to Christopher T. Lang, MD, Ohio State University Medical Center, 395 W 12th Ave, Fifth Floor, Columbus,.com Abbreviations 3D, 3-dimensional; 2D, 2-dimensional onographic measurement of cervical length is a well-established modality for identifying women at high risk for spontaneous preterm birth.

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Mechanical and biochemical properties of human cervical tissue

Cited by 178 publications

References 43 publications

Nonlinear optical microscopy and ultrasound imaging of human cervical structure

Nonlinear optical microscopy and ultrasound imaging of human cervical structure

Second harmonic generation imaging as a potential tool for staging pregnancy and predicting preterm birth

A Method to Visualize 3-Dimensional Anatomic Changes in the Cervix During Pregnancy

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