• DOI:10.1196/annals.1389.004
• Corpus ID: 42866098

In Vivo Characterization of the Mechanics of Human Uterine Cervices

@article{Bauer2007InVC,
  title={In Vivo Characterization of the Mechanics of Human Uterine Cervices},
  author={Margit Bauer and Edoardo Mazza and Alessandro Nava and Willibald Zeck and Martina Eder and Michael Bajka and Fernando Cacho and Uwe Lang and Gerhard A. Holzapfel},
  journal={Annals of the New York Academy of Sciences},
  year={2007},
  volume={1101}
}

• M. Bauer, E. Mazza, +6 authors G. Holzapfel
• Published 1 April 2007
• Medicine, Biology
• Annals of the New York Academy of Sciences

Abstract:  The uterine cervix has to provide mechanical resistance to ensure a normal development of the fetus. This is guaranteed by the composition of its extracellular matrix, which functions as a fiber‐reinforced composite. At term a complex remodeling process allows the cervical canal to open for birth. This remodeling is achieved by changes in the quality and quantity of collagen fibers and ground substance and their interplay, which influences the biomechanical behavior of the cervix but also contributes to pathologic conditions such as cervical incompetence (CI). We start by reviewing the anatomy and histological composition of the human cervix, and discuss its physiologic function and pathologic condition in pregnancy including biomechanical aspects. Established diagnostic methods on the cervix (palpation, endovaginal ultrasound) used in clinics as well as methods for assessment of cervical consistency (light‐induced fluorescence, electrical current, and impedance) are discussed. We show the first clinical application of an aspiration device, which allows in vivo testing of the biomechanical properties of the cervix with the aim to establish the physiological biomechanical changes throughout gestation and to detect pregnant women at risk for CI. In a pilot study on nonpregnant cervices before and after hysterectomy we found no considerable difference in the biomechanical response between in vivo and ex vivo. An outlook on further clinical applications during pregnancy is presented.