A Computational Framework for the Clinical Evaluation of the Soft Tissue Mechanics in Pregnancy

妊娠期软组织力学临床评估的计算框架

• 批准号: 10178057
• 负责人: Kristin Marie Myers
• 金额: $ 30.62万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10178057
• 关键词: Accounting; Amniotic Sac; Anatomy; Automobile Driving; Birth Rate; Cervical; Cervix Uteri; Characteristics; Clinical; Clinical Research; Computer Models; Contracts; Cues; Data; Development; Diagnostic; Elements; Emotional; Engineering; Environment; Evaluation; Failure; Fetal Membranes; Fetus; Fiber; Functional disorder; Future; Goals; Growth; Healthcare Systems; Intervention; Investigation; Knowledge; Lead; Measurement; Measures; Mechanical Stress; Mechanics; Methods; Modeling; Morbidity - disease rate; Nature; Organ; Organ failure; Patients; Perinatal mortality demographics; Physiological; Physiological Processes; Pregnancy; Premature Birth; Prenatal care; Process; Property; Research; Research Personnel; Risk; Risk Factors; Role; Rupture; Signal Transduction; Stress; Stretching; Structure; Testing; Therapeutic Intervention; Thromboplastin; Time; Tissue membrane; Tissues; Translating; Ultrasonography; Uterus; Woman; base; cervical remodeling; clinical Diagnosis; computational platform; computer framework; computerized tools; cost; design; early onset; fetal; flexibility; high risk; in vivo; mechanical force; mechanical load; minimally invasive; neonatal death; pregnant; prevent; recruit; research clinical testing; research study; simulation; societal costs; soft tissue; tissue stress; tool

PROJECT SUMMARY/ABSTRACT Despite advances in prenatal care, the rate of preterm birth in the US and around the world remains on the rise. This fact underscores how little we know about the causes of preterm birth, which is a leading cause of neonatal deaths. Our ultimate research goal is to reduce the preterm birth rate and the associated emotional and societal costs by providing a validated computational framework to identify the potential for mechanical dysfunction in pregnancy. Researchers and clinicians know that the healthy mechanical function of soft tissues surrounding the fetus is crucial for a successful pregnancy. Particularly, the uterus, fetal membrane, and cervix must withstand mechanical forces to protect, support, and maintain an optimal growth environment for the developing baby. The magnitude of stress and stretch of these tissues are thought to control physiologic processes that regulate tissue growth, remodeling, contractility, and rupture, and it is generally hypothesized that these mechanical signals are clinical cues for normal labor and preterm birth. Yet, the mechanical stress and stretch of these tissues during pregnancy have not been determined, limiting the understanding of vital mechnobiology processes in pregnancy. To understand what causes the mechanical dysfunction in pregnancy, we will build a finite element (FE) simulation framework to identify the anatomical and/or material factors that drive uterine, cervical, and fetal membrane tissue remodeling and deformation. To build and validate these computational models we will longitudinally measure the anatomical features and cervical tissue properties of pregnant patients who are at low- risk for preterm birth throughout pregnancy. We will also conduct multi-scale structure-function studies on ex vivo cervical, uterine, and fetal membrane tissue to equip our model with features of the underlying tissue ultrastructure. We will then construct a flexible, parameterized FE framework that can directly incorporate our experimental measurements. Lastly, we will validate the FE framework by assessing the predictive capabilities of the model based on experimental evidence, and we will conduct a sensitivity study of material and geometric parameters to uncover the driving factors of tissue stress and stretch. Upon completion of our proposed research study, we will have a computational model of pregnancy that can identify the mechanistic cause of cervical, uterine, and fetal membrane deformation and guide the development of appropriate clinical studies that target women who are at high-risk for preterm birth.

项目摘要/摘要 尽管在产前护理方面取得了进展，但美国和世界各地的早产率仍然 呈上升趋势。这一事实突显了我们对早产的原因知之甚少，这是一种 新生儿死亡的主要原因。我们的最终研究目标是降低早产率和 通过提供有效的计算框架来降低相关的情感和社会成本 确定妊娠期间发生机械功能障碍的可能性。研究人员和临床医生都知道 胎儿周围软组织的健康机械功能对手术成功至关重要 怀孕了。特别是，子宫、胎膜和宫颈必须承受机械力，以 为发育中的婴儿保护、支持和维持一个最佳的成长环境。这个 这些组织的应力和拉伸的大小被认为控制着 调节组织生长、重塑、收缩和破裂，通常假设 这些机械信号是正常分娩和早产的临床信号。然而，机械的 这些组织在怀孕期间的应力和拉伸尚未确定，限制了 了解妊娠期的重要机械生物学过程。为了了解是什么导致了 我们将构建一个有限元(FE)模拟框架，以 确定驱动子宫、宫颈和胎膜组织的解剖学和/或物质因素 重塑和变形。为了建立和验证这些计算模型，我们将纵向 测量低位妊娠患者的解剖学特征和颈部组织学特性 在怀孕期间有早产的风险。我们还将进行多尺度结构功能 体外宫颈、子宫和胎膜组织的研究使我们的模型具有以下特征 下层组织超微结构。然后，我们将构建一个灵活的、参数化的有限元框架 可以直接结合我们的实验测量结果。最后，我们将通过以下方式验证FE框架 根据实验证据评估模型的预测能力，我们将 进行材料和几何参数的敏感性研究，以揭示驱动因素 组织应力和拉伸。在完成我们建议的研究后，我们将会有一个 妊娠的计算模型，可以确定宫颈、子宫和子宫的机制原因 并指导制定合适的胎膜变形临床研究目标 有早产高风险的妇女。

项目成果

Material Properties of Nonpregnant and Pregnant Human Uterine Layers.

非怀孕和怀孕人类子宫层的材料特性。

• DOI: 10.1101/2023.08.07.551726
• 发表时间: 2023
• 期刊: bioRxiv : the preprint server for biology
• 作者: Fodera,DaniellaM;Russell,SerenaR;Lund-Jackson,JohannaL;Fang,Shuyang;Chen,Xiaowei;Vink,Joy-SarahY;Oyen,MichelleL;Myers,KristinM
• 通讯作者: Myers,KristinM

A Parameterized Ultrasound-Based Finite Element Analysis of the Mechanical Environment of Pregnancy.

基于参数化超声的妊娠机械环境有限元分析。

• DOI: 10.1115/1.4036259
• 发表时间: 2017
• 期刊: Journal of biomechanical engineering
• 作者: Westervelt,AndreaR;Fernandez,Michael;House,Michael;Vink,Joy;Nhan-Chang,Chia-Ling;Wapner,Ronald;Myers,KristinM
• 通讯作者: Myers,KristinM

Computer modeling tools to understand the causes of preterm birth.

• DOI: 10.1053/j.semperi.2017.08.007
• 发表时间: 2017-12
• 期刊: Seminars in perinatology
• 影响因子: 3.4
• 作者: Westervelt AR;Myers KM
• 通讯作者: Myers KM

Parametric Solid Models of the At-Term Uterus From Magnetic Resonance Images.

来自磁共振图像的足月子宫参数化实体模型。

• DOI: 10.1115/1.4065109
• 发表时间: 2024
• 期刊: Journal of biomechanical engineering
• 作者: Louwagie,ErinM;Rajasekharan,Divya;Feder,Arielle;Fang,Shuyang;Nhan-Chang,Chia-Ling;Mourad,Mirella;Myers,KristinM
• 通讯作者: Myers,KristinM