UTERINE CONTRACTILITY AND CERVICAL RIPENING IN PREGNANCY

怀孕期间与分娩有关的问题是最常见的 医生面临的重要健康问题。 理解的作用 分娩中的子宫和子宫颈，并制定控制其 功能是解决劳动问题的关键。 在 目前，只有粗糙，不准确和主观的方法来评估 在准备或期间发生的子宫和宫颈变化 劳动 在过去的几年里，申请人及其同事 开发了非侵入性方法来定量评估子宫， 分别基于子宫电信号的记录 从腹部表面（子宫肌电图）和测量光- 用光学装置诱导宫颈胶原荧光（LIF） （Collascope）。 该方法是快速的，并允许评估子宫 收缩力和宫颈成熟。在大鼠中的初步研究， 人类表明子宫和宫颈功能可以成功地 在怀孕期间使用这些方法进行监测， 技术可用于与以下情况相关的各种情况中： 更好地定义管理。 此申请是为了获得资金， 扩大初步研究。 四项研究建议使用腹部 EMB记录和宫颈LIF。 一个称职的调查小组， 工作人员已经聚集起来，以满足这一需求和目标， 提议 具体的假设是LIF和腹部肌电图 录音可以用来：1）区分真假 分娩; 2）预测分娩的开始; 3）在分娩期间监测患者 安胎或引产。 具体目的是利用肌电 活动和LIF，以确定它们是否有助于：1）评估患者 在真产与假产中; 2）监测产前患者 纵向; 3）检查宫缩抑制剂或诱导的有效性。 拟议的仪器和方法的潜在好处 包括降低早产率，改善产妇和新生儿的健康状况， 围生儿结局，监护治疗，减少剖宫产 率和改进研究方法，以了解子宫和宫颈 功能

The problems associated with labor during pregnancy are among the most important health issues facing physicians. Understanding the role of the uterus and cervix in labor and developing methods to control their function is essential to solving problems relating to labor. At the moment, only crude, inaccurate and subjective methods are used to assess changes in the uterus and cervix that occur in preparation for or during labor. In the past several years, the applicant and his colleagues have developed noninvasive methods to quantitatively evaluate the uterus and cervix based respectively on recording of uterine electrical signals from the abdominal surface (uterine EMG) and measurement of light- induced cervical collagen fluorescence (LIF) with an optical device (Collascope). The methods are rapid and allow assessment of uterine contractility and cervical ripening. Preliminary studies in rats and humans indicate that uterine and cervical function can be successfully monitored during pregnancy using these approaches and that these techniques might be used in a variety of conditions associated with labor to better define management. This application is for funds to extend the initial studies. Four studies are proposed using abdominal EMB recordings and cervical LIF. A competent team of investigators and staff has been assembled to fulfill the needs and goals of this proposal. The specific hypotheses are that LIF and abdominal EMG recordings can be used to: 1) differentiate between true and false labor; 2) predict the onset of labor; 3) monitor patients during tocolysis or induction of labor. The specific aims are to use EMG activity and LIF to determine if they are helpful to: 1) assess patients in true versus false labor; 2) monitor antepartum patients longitudinally; 3) examine the effectiveness of tocolytics or induction. The potential benefits of the proposed instrumentation and methods include reducing the rate of preterm delivery, improving maternal and perinatal outcome, monitoring treatment, decreasing cesarean section rate and improving research methods to understand uterine and cervical function.