Cervix Monitor for Elasticity and Length Measurements

Completed

Brief Summary: Preterm birth is a leading global cause of neonatal mortality despite of numerous advances and intensive research in perinatal medicine. Almost one million children die each year due to complications of preterm birth and in almost all countries with reliable data, preterm birth rates are increasing. Of the 14 million survivors per year, many face a lifetime of disability, including learning disabilities, visual and hearing impairments. Spontaneous preterm delivery (SPTD) is often multi factorial event, precocious cervical softening, shortening and dilatation are a common denominator. The majority of preterm births happen spontaneously, though some are due to early induction of labor or cesarean birth, typically due to medical maternal of neonatal conditions.

Detailed Description: The uterine cervix has to provide structural integrity and mechanical resistance to ensure normal development of the fetus as the uterus expands to accommodate the fetus growth. Preterm delivery is closely related to a premature cervical ripening. The scientific bases for the proposed project is the elasticity modulus of a cervix is a more sensitive parameter characterizing the stage of cervical ripening. The main component of the cervix tissue is a collagen. Cervical ripening is the result of realignment of collagen, degradation of collagen cross-linking due to proteolytic enzymes. These processes affect the elasticity modulus of the cervical tissue. Therefore, assessment of cervix by a device measuring cervical elasticity and cervical length appears to be and adequate approach for identifying pregnant women at high risk of spontaneous preterm delivery. The primary cervical elasticity assessment currently used in clinical practice is relying on the evaluation of the cervix as "hard, medium or soft". In the scope of this project the investigators propose to develop and clinically validate a new and cost-effective device, Cervix Monitor for detecting cervix conditions leading to SPTD and its risk assessment. The CM will be based on measuring of the applied pressure to the cervix by a tactile sensor array and ultrasound measurement of cervix length .

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Active cancer of the colon, rectum wall, cervix, vaginal, uterus or bladder
Ongoing or prior radiation therapy for abdominal or pelvic cancer
Recent (less than four months) pelvic surgery
Surgically absent uterus, rectum or bladder
Significant circulatory or cardiac conditions that could cause excessive risk from the examination as determined by attending physician
Severe abdominal or pelvic adhesions preventing access to pertinent anatomy
Known or suspected bleeding disorder
HIV or hepatitis B positive serology
Warty lesions on the vulva
Extensive varicose veins on the vulva
Active skin infection or ulceration within the vagina/vulva (Herpes infection)
Presence of a vaginal septum
Severe hemorrhoids

Arm && Interventions

Group	Intervention	Description
Group 1: Non-pregnant women	Measurement	Non-pregnant women with normal pelvic floor
Group 2: Pregnant women	Measurement	Pregnant women; 22-29 weeks of pregnancy

Primary Outcome Measures

Name	Time	Method
Cervix Elasticity	During examination procedure	Young's modulus of the cervix at 4 locations. Units of measurement is kPa.

Secondary Outcome Measures

Name	Time	Method
Cervix Length	During examination procedure	Cervix length in mm

Locations (2): Princeton Urogynecology
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Princeton, New Jersey, United States
Rutgers Robert Wood Johnson Medical School
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New Brunswick, New Jersey, United States