Assessment of Uterine Contractility and Cervical Ripening During Pregnancy

妊娠期间子宫收缩力和宫颈成熟度的评估

• 批准号: 7116413
• 负责人: Robert E Garfield
• 金额: $ 40.39万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-02-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7116413
• 关键词: birth; cervix; cesarean section; clinical research; collagen; disease /disorder proneness /risk; electromyography; ethnic group; fluorescence; human subject; labor complications; muscle contraction; obstetrics; patient oriented research; pregnancy; premature labor; uterus

DESCRIPTION (provided by applicant): Problems associated with labor during pregnancy are some of the most important issues for physicians. These problems include diagnosis of term and preterm labor, and treatments associated with labor. We have developed noninvasive methods to quantitatively evaluate the uterus and cervix during pregnancy based on recording of uterine electrical signals from the abdominal surface (uterine EMG) and measurement of light induced cervical collagen fluorescence (cervical LIF) with an optical device called the Collascope. Only these two devices can currently give a direct measure of uterine and cervical function, which is critical for assessing the state of pregnancy. Current methods, such as tocodynamometery, ultrasound, and fetal fibronectin, cannot do this, so current tools for obstetricians are completely inadequate for proper evaluation of pregnant patients. This application is to renew our previous grant and the associated initial studies. Three studies are proposed using uterine EMG recordings and cervical LIF measurements. The specific hypotheses are: 1.) Labor and delivery can be accurately predicted using cervical LIF and uterine EMG variables individually, and when combined in a multivariate model 2.) Parturition complications and c-section likelihood can be forecast using uterine EMG and cervical LIF measurements to identify high-risk groups. 3.) Uterine EMG and cervical LIF measurements can be used to determine differences in patients with cervical insufficiency. The specific aims are to: 1.) Improve predictive capability of various uterine/cervical variables using LIF and EMG. 2.) Assess uterine EMG and cervical LIF as predictive indicators, and to determine their correlation with c-section and complication incidence in patients, specifically by ethnic subgroups and with infection. 3.) Characterize uterine EMG and cervical LIF in patients with cervical insufficiency. The potential benefits of these studies are substantial, and include effective diagnosis of term and preterm labor, reduction in rate of preterm labor, improvement in maternal and perinatal outcome, better selection of treatments, a decrease in cesarean section rate, and improvement in obstetrical research. In this second and final resubmission, we have responded to the reviewer's critiques, updated the data, and corrected or amended the specific aims and text of the grant. We have maintained Dr. Gary Hankins, Chief of Division of Maternal-Fetal Medicine, Department of Ob/Gyn, in the project (see Dr. Hankins' letter of support in the Appendix).

描述（由申请人提供）：怀孕期间与劳动有关的问题是医生最重要的问题。这些问题包括诊断术语和早产劳动以及与劳动有关的治疗。我们已经开发了非侵入性方法，用于根据腹表面（子宫EMG）的子宫电信号的记录以及光诱导宫颈胶原蛋白荧光（宫颈LIF）测量的子宫和子宫颈在妊娠期间对子宫和子宫颈进行了数量评估。目前，只有这两种设备可以直接衡量子宫和宫颈功能，这对于评估妊娠状态至关重要。当前的方法，例如托管动力学，超声和胎儿纤连蛋白，无法做到这一点，因此目前的产科医生的工具完全不足以适当评估怀孕的患者。该应用是要续签我们以前的赠款和相关的初始研究。使用子宫EMG记录和宫颈LIF测量结果提出了三项研究。特定的假设为：1。）可以使用宫颈LIF和子宫EMG变量来准确预测劳动力和分娩，并且在多变量模型2中组合时，可以使用子宫EMG和宫颈LIF测量值进行预测和剖腹产并发症。 3.）子宫EMG和宫颈LIF测量可用于确定宫颈功能不全患者的差异。具体目的是：1。）使用LIF和EMG提高各种子宫/宫颈变量的预测能力。 2.）将子宫EMG和宫颈LIF评估为预测指标，并确定其与患者的剖腹产和并发症发生率的相关性，特别是族裔亚组和感染。 3.）表征子宫颈功能不全患者的子宫EMG和宫颈LIF。这些研究的潜在益处是很大的，包括有效诊断为期限和早产，早产率的降低，孕产妇和围产期结局的改善，更好地选择治疗方法，剖腹产率降低以及占用性研究的改善。在第二个也是最后一次重新提交中，我们回应了审稿人的批评，更新了数据，并纠正或修改了赠款的具体目的和文本。我们在该项目中维持了OB/Gyn的母亲医学司长Gary Hankins博士（请参阅附录中的Hankins博士支持信）。