Cervical Remodeling in the Postpartum Period

产后宫颈重塑

• 批准号: 10829643
• 负责人: Michelle Villegas-Downs
• 金额: $ 0.1万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-21 至 2024-01-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10829643
• 关键词: 37 weeks gestation; Accounting; Animals; Biological Markers; Biopsy; Birth; Cerebral Palsy; Cervical; Cervix Uteri; Characteristics; Collagen; Developmental Delay Disorders; Elastic Tissue; Elasticity; Enrollment; Fetus; Funding; Goals; Human; Infant; Knowledge; Labor Onset; Learning; Measures; Mechanics; Membrane; Pilot Projects; Postpartum Period; Pregnancy; Premature Birth; Premature Infant; Preparation; Process; Property; Public Health; Rattus; Recording of previous events; Recurrence; Reporting; Research; Research Personnel; Risk; Risk Factors; Rupture; Signal Transduction; Societies; Speed; Structure; Symptoms; System; Technology; Time; Tissues; Ultrasonics; United States; Uterus; Woman; Work; attenuation; cervical biopsy; cervical remodeling; clinical practice; cost; healing; infant death; innovation; longitudinal, prospective study; personalized intervention; pregnant; premature; prevent; quantitative ultrasound; ultrasound

ABSTRACT 380,000 infants are born preterm each year and account for 67% of infant deaths. Currently, there are no early, reliable, non-invasive indicators to determine the risk for spontaneous preterm birth before symptoms arise. Nevertheless, women who have delivered prematurely are at a 30% increased risk of recurrent preterm birth making a previous spontaneous preterm birth the strongest known risk factor for recurrence. Recently, investigators have reported that women who deliver spontaneous preterm have decreased collagen concentration and increased collagen disorganization early in gestation that can contribute to a mechanically weak cervix; however, the process of cervical remodeling after delivery is poorly understood and only a few studies have investigated collagen concentration and organization after birth. Due to a lack of noninvasive technology, it was never before possible to evaluate human cervical microstructure without a biopsy. For the first time, the opportunity to measure the collagen and elastic properties of the cervix noninvasively is possible with quantitative ultrasound (QUS). Innovative, noninvasive QUS technology specialized to detect microstructure changes in tissue has shown promise in detecting cervical changes in the pregnant rat cervix and in human pilot studies. In this prospective, longitudinal study, the aim is to determine the feasibility of conducting a yearlong study that evaluates whether changes in human cervical remodeling that led to spontaneous preterm birth continued in the postpartum period. Furthermore, investigators will attempt to fill the scientific gap in knowledge by determining if low ultrasound biomarkers (attenuation, backscatter coefficient, and shear wave speed) during pregnancy and postpartum were associated with spontaneous preterm birth. Ultimately, the goal is to determine the feasibility of conducting the study and to determine if ultrasound biomarkers will provide a scientific basis to accurately identify women at risk for recurrent spontaneous preterm birth.

抽象的 每年有 380,000 名婴儿早产，占婴儿死亡人数的 67%。目前，尚无早期、 可靠的非侵入性指标，可在症状出现之前确定自发性早产的风险。 然而，早产妇女复发性早产的风险增加 30% 使先前的自发性早产成为已知的最强的复发风险因素。最近， 研究人员报告称，自然早产的女性胶原蛋白减少 妊娠早期胶原蛋白的浓度和分解增加，这可能会导致机械性的 子宫颈薄弱；然而，人们对产后宫颈重塑的过程知之甚少，只有少数人了解产后宫颈重塑的过程。 研究调查了出生后胶原蛋白的浓度和组织。由于缺乏无创 随着技术的进步，以前不可能在不进行活检的情况下评估人体宫颈的微观结构。对于 第一次有机会以无创方式测量子宫颈的胶原蛋白和弹性特性 定量超声（QUS）。专门用于检测的创新、非侵入性 QUS 技术 组织的微观结构变化在检测怀孕大鼠子宫颈的宫颈变化方面显示出了希望 在人类试点研究中。在这项前瞻性纵向研究中，目的是确定进行 一项为期一年的研究，评估人类宫颈重塑的变化是否会导致自发性早产 产后期继续分娩。此外，研究人员将试图填补这方面的科学空白。 通过确定是否存在低超声生物标志物（衰减、后向散射系数和剪切波）来获取知识 怀孕期间和产后的速度）与自发性早产有关。最终，目标 是为了确定进行研究的可行性并确定超声生物标志物是否会提供 准确识别有反复自发性早产风险的妇女的科学依据。