Investigating the mechanical function of the cervix during pregnancy using finite element models derived from high-resolution 3D MRI.
Investigating the mechanical function of the cervix during pregnancy using finite element models derived from high-resolution 3D MRI.
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DOI：
10.1080/10255842.2015.1033163
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发表时间：
2016
影响因子：
1.6
通讯作者：
Myers K
中科院分区：
文献类型：
--
作者：
Fernandez M;House M;Jambawalikar S;Zork N;Vink J;Wapner R;Myers K
早产是围产期死亡率的一个重要因素，存活的早产儿有长期发病的风险。在大多数怀孕期间，子宫颈需要适当的机械功能来维持子宫内发育的胎儿。子宫颈过早软化和随后的子宫颈缩短被认为是导致早产的原因。目前，对影响妊娠期子宫颈机械功能的结构和材料因素缺乏了解。在这项研究中，我们建立有限元（FE）模型的怀孕子宫，子宫颈，和胎膜的基础上磁共振成像（MRI）的数据，以检查子宫颈的力学功能下的生理负荷条件下的怀孕。我们计算了两个怀孕患者的宫颈的机械负荷状态：22周胎龄正常宫颈长度和28周宫颈短。我们研究了1）解剖学几何结构2）宫颈材料特性和3）胎膜材料特性（包括其粘附特性）对生理相关宫内压力下宫颈机械负荷状态的影响。我们的研究表明，膜-子宫相互作用，宫颈材料建模，和膜的机械性能的因素，必须故意和小心处理，以构建一个高质量的机械模拟怀孕。
Preterm birth is a strong contributor to perinatal mortality, and preterm infants that survive are at risk for long-term morbidities. During most of pregnancy appropriate mechanical function of the cervix is required to maintain the developing fetus in utero. Premature cervical softening and subsequent cervical shortening are hypothesized to cause preterm birth. Presently, there is a lack of understanding of the structural and material factors that influence the mechanical function of the cervix during pregnancy. In this study we build finite element (FE) models of the pregnant uterus, cervix, and fetal membrane based on magnetic resonance imagining (MRI) data in order to examine the mechanical function of the cervix under the physiologic loading conditions of pregnancy. We calculate the mechanical loading state of the cervix for two pregnant patients: 22 weeks gestational age with a normal cervical length and 28 weeks with a short cervix. We investigate the influence of 1) anatomical geometry 2) cervical material properties, and 3) fetal membrane material properties, including its adhesion properties, on the mechanical loading state of the cervix under physiologically relevant intrauterine pressures. Our study demonstrates that membrane-uterus interaction, cervical material modeling, and membrane mechanical properties are factors that must be deliberately and carefully handled in order to construct a high quality mechanical simulation of pregnancy.