Direct Measurement of the Permeability of Human Cervical Tissue

Author:

Fernandez Michael1,Vink Joy2,Yoshida Kyoko3,Wapner Ronald4,Myers Kristin M.5

Affiliation:

1. Graduate Research Assistant Deptarment of Mechanical Engineering, Columbia University, New York, NY 10027 e-mail:

2. Assistant Clinical Professor Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032 e-mail:

3. Graduate Research Assistant Department of Mechanical Engineering, Columbia University, New York, NY 10027 e-mail:

4. Vice Chairman for Research Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032 e-mail:

5. Assistant Professor Department of Mechanical Engineering, Columbia University, New York, NY 10027 e-mail:

Abstract

The mechanical integrity of the uterine cervix is critical for a pregnancy to successfully reach full term. It must be strong to retain the fetus throughout gestation and then undergo a remodeling and softening process before labor for delivery of the fetus. It is believed that cervical insufficiency (CI), a condition in pregnancy resulting in preterm birth (PTB), is related to a cervix with compromised mechanical strength which cannot resist deformation caused by external forces generated by the growing fetus. Such PTBs are responsible for infant developmental problems and in severe cases infant mortality. To understand the etiologies of CI, our overall research goal is to investigate the mechanical behavior of the cervix. Permeability is a mechanical property of hydrated collagenous tissues that dictates the time-dependent response of the tissue to mechanical loading. The goal of this study was to design a novel soft tissue permeability testing device and to present direct hydraulic permeability measurements of excised nonpregnant (NP) and pregnant (PG) human cervical tissue from women with different obstetric histories. Results of hydraulic permeability testing indicate repeatability for specimens from single patients, with an order of magnitude separating the NP and PG group means (2.1 ± 1.4×10-14 and 3.2 ± 4.8×10-13m4/N·s, respectively), and large variability within the NP and PG sample groups. Differences were found between samples with similar obstetric histories, supporting the view that medical history may not be a good predictor of permeability (and therefore mechanical behavior) and highlighting the need for patient-specific measurements of cervical mechanical properties. The permeability measurements from this study will be used in future work to model the constitutive material behavior of cervical tissue and to develop in vivo diagnostic tools to stage the progression of labor.

Publisher

ASME International

Subject

Physiology (medical),Biomedical Engineering

Reference52 articles.

1. The Worldwide Incidence of Preterm Birth: A Systematic Review of Maternal Mortality and Morbidity;Bull. World Health Organ.,2010

2. National Vital Statistics Reports: Births: Final Data for 2006, CDC/National Center for Health Statistics;National Center for Health,2006

3. Epidemiology and Causes of Preterm Birth;Lancet,2008

4. Glucose Regulation in Young Adults With Very Low Birth Weight;N. Engl J. Med.,2007

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