The mechanical role of the cervix in pregnancy.
- Myers KM Department of Mechanical Engineering, Columbia University, New York, NY, USA. Electronic address: kmm2233@columbia.edu.
- Feltovich H Department of Obstetrics and Gynecology, Intermountain Healthcare, Provo, UT, USA; Department of Medical Physics, University of Wisconsin, Madison, WI, USA.
- Mazza E Department of Mechanical and Process Engineering, ETH Zurich, & EMPA Dübendorf, Switzerland.
- Vink J Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY USA.
- Bajka M Department of Obstetrics and Gynecology, University Hospital of Zurich, Switzerland.
- Wapner RJ Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY USA.
- Hall TJ Department of Medical Physics, University of Wisconsin, Madison, WI, USA.
- House M Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA, USA.
- 2015-04-06
Published in:
- Journal of biomechanics. - 2015
Cervix
Pregnancy
Preterm birth
Animals
Biomechanical Phenomena
Cervix Uteri
Collagen
Female
Humans
Models, Biological
Pregnancy
Premature Birth
English
Appropriate mechanical function of the uterine cervix is critical for maintaining a pregnancy to term so that the fetus can develop fully. At the end of pregnancy, however, the cervix must allow delivery, which requires it to markedly soften, shorten and dilate. There are multiple pathways to spontaneous preterm birth, the leading global cause of death in children less than 5 years old, but all culminate in premature cervical change, because that is the last step in the final common pathway to delivery. The mechanisms underlying premature cervical change in pregnancy are poorly understood, and therefore current clinical protocols to assess preterm birth risk are limited to surrogate markers of mechanical function, such as sonographically measured cervical length. This is what motivates us to study the cervix, for which we propose investigating clinical cervical function in parallel with a quantitative engineering evaluation of its structural function. We aspire to develop a common translational language, as well as generate a rigorous integrated clinical-engineering framework for assessing cervical mechanical function at the cellular to organ level. In this review, we embark on that challenge by describing the current landscape of clinical, biochemical, and engineering concepts associated with the mechanical function of the cervix during pregnancy. Our goal is to use this common platform to inspire novel approaches to delineate normal and abnormal cervical function in pregnancy.
- Language
-
- English
- Open access status
- bronze
- Identifiers
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- DOI 10.1016/j.jbiomech.2015.02.065
- PMID 25841293
- Persistent URL
- https://sonar.ch/global/documents/267350
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