Wednesday, March 13, 2019

Childbirth: Still a Frontier

Image result for cervixEnvironmental & Science Education
Nature of Science
History of Science
Edward Hessler

When we think about faculty in an obstetrics and gynecology department we don't often, if ever, think that one of them might be a mechanical engineer. However, there is one ob/gyn department with such a faculty member. 

NPR's Alison Kodjak recently reported on the research of obstetrician Dr. Joy Sarah Vink and mechanical engineer, Dr. Kristin Myer of Columbia University. Dr. Vink is the co-founder of the Preterm Birth Prevention Center at Columbia University Medical Center. 

What brings this team together is the mechanics and physiology of the cervix and the problem of preventing premature labor. I was surprised to read the following statement by Dr. Vink. "It's mind-boggling that in this day and age, we still don't understand [even] in a normal pregnancy how women go into labor--what triggers labor."  

Kodjack notes that this focus on the cervix is that if "doctors can get the cervix to stay closed in those final crucial weeks of gestation, the baby won't be born too soon, even if the amniotic sac breaks." The article notes that "there are about 1 in 10 premature births in the U. S. each year." Vink is studying what the cervix is made of. One finding is that the cervix has been long thought to be made of collagen but it turns out it has "a lot of muscle."

Image result for pregnancyMyer is studying how the cervix works. As an undergraduate she did research on how tires respond to heat. Then as a graduate student at MIT she worked with a team "who were interested in the mechanics of pregnancy." Myers's work with Vink includes the construction of computational models and "the biomechanics of pregnancy--from how much the uterus can stretch, to how much pressure pregnancy exerts on the cervix, to how much force a baby's kick puts on the whole system." One finding is that the "stiffness (of the cervix) of pregnant tissues compared to non-pregnant tissues changes by three orders of magnitude."

"All those measurements," Kodjak writes, "go into a databank. And when women in Vink's practice get an ultrasound, the technicians spend an extra few minutes measuring the mother's anatomy, as well as the baby's.... Then the team uses their computer models to look at how the various factors--shape, stretch, pressure and tissue strength--interact as a woman moves toward labor and childbirth. Their goal is to be able to examine a pregnant woman early on, and accurately predict whether she will go into labor too soon. It's a first step, Vink hopes, toward better interventions to stop that labor."

Please read Kodjak's full article for details.

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