Investigation of cervical remodeling during pregnancy with in vivo Raman spectroscopy
O'Brien, Christine Mary
:
2018-01-26
Abstract
Monitoring cervical composition during pregnancy has high potential for prediction of preterm
birth, a problem affecting 15 million newborns annually. In vivo Raman spectroscopy (RS) is an
optical technique that can measure the biochemical composition of tissue non-invasively in
humans. In this dissertation, it has been utilized to measure the cervix of over 80 women during
pregnancy, labor, and post-partum repair to characterize normal spectral changes that occur.
Significant changes were observed in collagen, actin, blood, lipid, and glycogen signals, and
patient factors including body mass index and prior pregnancy were found to have significant
effects on Raman spectra. To aid with patient recruitment and clinical translation, a visually-guided
Raman probe was developed and tested that does not require the use of a speculum, a deterrent of
patient enrollment. Furthermore, a mouse model of delayed delivery was investigated using RS
and found to have a cervical remodeling defect, demonstrating the utility of this approach for
identifying abnormal cervical remodeling. This foundational study demonstrates sensitivity to
known biochemical dynamics that occur during cervical remodeling, and takes important steps
towards clinical translation. RS has the potential to unveil information that is not detectable with
current clinical approaches, which could allow for more targeted diagnostic and therapeutic
strategies for preterm birth.