The biomechanical evolution of the uterus and cervix and fetal growth in human pregnancy
The coordinated biomechanical performance of maternal tissues facilitates healthy pregnancy. Quantifying uterine and cervical biomechanical function has been challenging due to minimal data on the anatomy's shape, size, and material properties across gestation. Addressing this challenge, this study quantifies structural features of human pregnancy by assessing maternal reproductive tissues and estimated fetal weight in 47 low-risk pregnancies at four gestation times. Uterocervical size and estimated fetal weight were measured via ultrasound, and cervical stiffness was measured via mechanical aspiration. Patient-specific uterocervical solid models were built for each time point, and uterocervical dimensions and cervical stiffness rate changes were assessed between time points. We found that uterine growth rates are time- and direction-dependent, with cervical softening occurring fastest in early gestation and cervical shortening fastest in late gestation. In conclusion, this work enables computational modeling platforms (i.e., digital twins) to explore the structural performance of the uterus and cervix in pregnancy.
Authors
- S. Russell (ORCID: https://orcid.org/0000-0002-4470-5761)
- Michael House (ORCID: https://orcid.org/0000-0002-4274-5786)
- Whitney A. Booker (ORCID: https://orcid.org/0000-0003-0405-069X)
- Joy Vink (ORCID: https://orcid.org/0000-0002-5107-5278)
- Alexander Michael Friedman (ORCID: https://orcid.org/0000-0001-5246-0824)
- Kristin M. Myers (ORCID: https://orcid.org/0000-0002-5989-0242)
- Noelia Zork (ORCID: https://orcid.org/0000-0001-8675-1806)
- Cynthia Gyamfi‐Bannerman (ORCID: https://orcid.org/0000-0002-3026-2277)
- Maria Andrikopoulou (ORCID: https://orcid.org/0000-0002-5458-2822)
- Ronald J. Wapner (ORCID: https://orcid.org/0000-0003-0727-1244)
- Helen Feltovich (ORCID: https://orcid.org/0000-0001-5303-9265)
- Mirella Mourad (ORCID: https://orcid.org/0000-0003-1534-9259)
- Erin Louwagie (ORCID: https://orcid.org/0000-0001-6384-0777)
- Jacqueline C. Hairston (ORCID: https://orcid.org/0000-0003-3340-1890)
- Karin Fuchs
- Claire Nottman
- Chia-Ling Nhan-Chang
Institutions
- Northwestern University (US)
- Tufts Medical Center (US)
- Columbia University Irving Medical Center (US)
- UC San Diego Health System (US)
- University of California San Diego (US)
- Pacific Health Research and Education Institute (US)
- Columbia University (US)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- npj Women s Health
- Published
- 2024-10-03
- DOI
- https://doi.org/10.1038/s44294-024-00038-8
- Citations
- 7
- Primary Topic
- Preterm Birth and Chorioamnionitis
- Type
- article
- Field-Weighted Citation Impact
- 2.71
Funders
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development