Longitudinal ultrasonic dimensions and parametric solid models of the gravid uterus and cervix

Tissue mechanics is central to pregnancy, during which maternal anatomic structures undergo continuous remodeling to serve a dual function to first protect the fetus in utero while it develops and then facilitate its passage out. In this study of normal pregnancy using biomechanical solid modeling,...

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Bibliographic Details
Published in:PloS one 2021-01, Vol.16 (1), p.e0242118-e0242118
Main Authors: Louwagie, Erin Marie, Carlson, Lindsey, Over, Veronica, Mao, Lu, Fang, Shuyang, Westervelt, Andrea, Vink, Joy, Hall, Timothy, Feltovich, Helen, Myers, Kristin
Format: Article
Language:English
Subjects:
Adult
Biology and Life Sciences
Biomechanics
CAD
Cervix
Cervix uteri
Cervix Uteri - diagnostic imaging
Cervix Uteri - physiology
Cesarean section
Childbirth & labor
Collagen
Computer aided design
Data acquisition
Drafting software
Editing
Female
Fetuses
Funding
Gestation
Gestational Age
Gynecology
Health care facilities
Humans
Imaging, Three-Dimensional
Informatics
Longitudinal Studies
Magnetic resonance imaging
Mechanical engineering
Medical examination
Medicine and Health Sciences
Methodology
Models, Biological
Obstetrics
Patients
Physiological research
Pregnancy
Pregnancy - physiology
Premature birth
Research and Analysis Methods
Surgery
Three dimensional models
Ultrasonic imaging
Ultrasonography, Prenatal
Ultrasound
Ultrasound imaging
Uterus
Vascular diseases
Visualization
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Summary:Tissue mechanics is central to pregnancy, during which maternal anatomic structures undergo continuous remodeling to serve a dual function to first protect the fetus in utero while it develops and then facilitate its passage out. In this study of normal pregnancy using biomechanical solid modeling, we used standard clinical ultrasound images to obtain measurements of structural dimensions of the gravid uterus and cervix throughout gestation. 2-dimensional ultrasound images were acquired from the uterus and cervix in 30 pregnant subjects in supine and standing positions at four time points during pregnancy (8-14, 14-16, 22-24, and 32-34 weeks). Offline, three observers independently measured from the images of multiple anatomic regions. Statistical analysis was performed to evaluate inter-observer variance, as well as effect of gestational age, gravity, and parity on maternal geometry. A parametric solid model developed in the Solidworks computer aided design (CAD) software was used to convert ultrasonic measurements to a 3-dimensional solid computer model, from which estimates of uterine and cervical volumes were made. This parametric model was compared against previous 3-dimensional solid models derived from magnetic resonance frequency images in pregnancy. In brief, we found several anatomic measurements easily derived from standard clinical imaging are reproducible and reliable, and provide sufficient information to allow biomechanical solid modeling. This structural dataset is the first, to our knowledge, to provide key variables to enable future computational calculations of tissue stress and stretch in pregnancy, making it possible to characterize the biomechanical milieu of normal pregnancy. This vital dataset will be the foundation to understand how the uterus and cervix malfunction in pregnancy leading to adverse perinatal outcomes.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0242118