Collagen content, blood perfusion, and tissue elasticity in the cervix of women at risk of Preterm Birth

With an estimated 15 million neonates born prematurely annually, preterm birth (PTB) is the leading cause of neonatal mortality and morbidity worldwide.Preterm infants are at an increased risk for severe health problems and death.

It is well known that premature cervical changes are the major cause of PTB.However, universal screening by traditional transvaginal ultrasound at 18-24 gestational weeks, can only identify up to 35% of the women that go on to having PTB.We therefore do not know how to best identify the majority of women that suffer from PTB (65%).This research project will use a novel imaging modality that combines endocavity ultrasound and photoacoustic (ECUSPA) imaging.The first phase of the project will test the device in the clinical setting on a group of non-pregnant women volunteers.Average examination time, tissue temperature increase,reproducibility of measurements and inter-observer independency will be measured.The second phase of the project will evaluate the ECUSPA system on a group of women at high risk for PTB.These women will undergo assessment at 26 wks of gestation and thereafter at 2 wk intervals.This combined evaluation will provide new information on the tensile properties of the cervix, collagen concentration and blood perfusion.The prevalence of PTB will be noted and correlated to ECUSPA imaging.We will develop prediction models which will help in the early identification of women at risk for PTB, in time for life saving medical interventions.