In vivo Raman spectroscopy monitors cervical change during labor - 20/07/22
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Abstract |
Background |
Biochemical cervical change during labor is not well understood, in part, because of a dearth of technologies capable of safely probing the pregnant cervix in vivo. The need for such a technology is 2-fold: (1) to gain a mechanistic understanding of the cervical ripening and dilation process and (2) to provide an objective method for evaluating the cervical state to guide clinical decision-making. Raman spectroscopy demonstrates the potential to meet this need, as it is a noninvasive optical technique that can sensitively detect alterations in tissue components, such as extracellular matrix proteins, lipids, nucleic acids, and blood, which have been previously established to change during the cervical remodeling process.
Objective |
We sought to demonstrate that Raman spectroscopy can longitudinally monitor biochemical changes in the laboring cervix to identify spectral markers of impending parturition.
Study Design |
Overall, 30 pregnant participants undergoing either spontaneous or induced labor were recruited. The Raman spectra were acquired in vivo at 4-hour intervals throughout labor until rupture of membranes using a Raman system with a fiber-optic probe. Linear mixed-effects models were used to determine significant (P<.05) changes in peak intensities or peak ratios as a function of time to delivery in the study population. A nonnegative least-squares biochemical model was used to extract the changing contributions of specific molecule classes over time.
Results |
We detected multiple biochemical changes during labor, including (1) significant decreases in Raman spectral features associated with collagen and other extracellular matrix proteins (P=.0054) attributed to collagen dispersion, (2) an increase in spectral features associated with blood (P=.0372), and (3) an increase in features indicative of lipid-based molecules (P=.0273). The nonnegative least-squares model revealed a decrease in collagen contribution with time to delivery, an increase in blood contribution, and a change in lipid contribution.
Conclusion |
Our findings have demonstrated that in vivo Raman spectroscopy is sensitive to multiple biochemical remodeling changes in the cervix during labor. Furthermore, in vivo Raman spectroscopy may be a valuable noninvasive tool for objectively evaluating the cervix to potentially guide clinical management of labor.
Le texte complet de cet article est disponible en PDF.Key words : biochemical, induction, labor management, optical, preterm labor, spectroscopy, technology
Plan
L.E.M. and C.M.O.B. share first authorship. |
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The authors report no conflict of interest. |
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This work was funded in part by the National Institutes of Health (NIH; grant numbers R01 HD081121, R01 CA095405, and T32 EB021937; L.E.M.), the National Science Foundation Graduate Research Fellowship (C.M.O.B.), and the Clinical and Translational Science Awards (grant number UL1TR000445) from the National Center for Advancing Translational Sciences (NCATS). |
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These funding sources did not have any involvement in the study design; collection, analysis, and interpretation of data; or decision to submit this article for publication. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCATS or the NIH. |
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Data will be made available on request by contacting the corresponding author. |
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Cite this article as: Masson LE, O’Brien CM, Gautam R, et al. In vivo Raman spectroscopy monitors cervical change during labor. Am J Obstet Gynecol 2022;227:275.e1-14. |
Vol 227 - N° 2
P. 275.e1-275.e14 - août 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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