Preterm Risk Assessment

utilizing nonlinear endomicroscopy imaging of cervical collagen fibers.

Introduction:

The cervix is a connective tissue-rich structure in the lower portion of the uterus in female mammals. It has a major role in childbirth. Appropriate remodeling of the cervix during gestation is an essential component of the birth process. The cervix must remain closed during pregnancy to maintain the fetus in the womb, and then open sufficiently to allow passage of the fetus at term. Abnormal or inappropriately timed cervical remodeling can lead to premature birth (PTB).

PTB, which accounts for 12.7% of all births in the United States, is the second leading cause of infant mortality and often leads to serious morbidity in surviving infants. Despite considerable research, the cause of PTB in 50% of cases remains elusive, and diagnostic methods to detect women at risk of PTB are limited. Because clinical and animal studies suggest that cervical changes precede the onset of uterine contractility in both term and PTB, premature cervical changes could be indicative of impending PTB. The progressive structural changes in fibrillar collagens are directly related to cervical rigidity and thus potentially can serve as a diagnostic indicator for women at risk for PTB.

Ongoing work:

Our lab is actively investigating the use of second-harmonic generation (SHG) endomicroscopy for imaging the collagen fibers of cervical connective tissue. Figure 1 shows some of our results on mouse models, where the changes throughout pregnancy are clearly visible, as was also correlated with histology. For more information on the technology, please see our Nonlinear endomicroscopy page, and for more information on this application, please refer to our paper: Y. Y. Zhang, et. al., PNAS 109 (2012).

Figure 1. SHG endomicroscopy images of mouse cervical tissues with the corresponding histology slides. See more details in Y. Y. Zhang, et. al., PNAS 109 (2012) (Click to enlarge and view detailed caption)



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