Methods and devices for the management of term and preterm labor

R. E. Garfield, H. Maul, L. Shi, W. Maner, C. Fittkow, G. Olsen, George Saade

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labor. This step is not easily identifiable with present methods designed to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties that make muscle more excitable and responsive and produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone and nitric oxide appear to have important roles in these processes. The progress of labor can be assessed noninvasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labor. EMG activity also increases substantially during preterm labor in humans and rats and may be predictive of preterm labor. A quantitative method for assessing the cervix is also described. A collascope estimates cervical collagen content from a fluorescent signal generated when collagen crosslinks are illuminated with an excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy and indicate controls and treatments.

Original languageEnglish (US)
Pages (from-to)203-224
Number of pages22
JournalAnnals of the New York Academy of Sciences
Volume943
StatePublished - 2001

Fingerprint

Premature Obstetric Labor
Cervix Uteri
Personnel
Equipment and Supplies
Rats
Pregnancy
Uterus
Animal Pregnancy
Collagen
Myometrium
Connective Tissue
Progesterone
Muscle
Reading
Nitric Oxide
Animals
Electric properties
Labor
Tissue
Light

Keywords

  • Cervix
  • Collagen
  • Electromyographic signals
  • Labor
  • Myometrium
  • Nitric oxide
  • Preterm labor
  • Progesterone

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Garfield, R. E., Maul, H., Shi, L., Maner, W., Fittkow, C., Olsen, G., & Saade, G. (2001). Methods and devices for the management of term and preterm labor. Annals of the New York Academy of Sciences, 943, 203-224.

Methods and devices for the management of term and preterm labor. / Garfield, R. E.; Maul, H.; Shi, L.; Maner, W.; Fittkow, C.; Olsen, G.; Saade, George.

In: Annals of the New York Academy of Sciences, Vol. 943, 2001, p. 203-224.

Research output: Contribution to journalArticle

Garfield, RE, Maul, H, Shi, L, Maner, W, Fittkow, C, Olsen, G & Saade, G 2001, 'Methods and devices for the management of term and preterm labor', Annals of the New York Academy of Sciences, vol. 943, pp. 203-224.
Garfield RE, Maul H, Shi L, Maner W, Fittkow C, Olsen G et al. Methods and devices for the management of term and preterm labor. Annals of the New York Academy of Sciences. 2001;943:203-224.
Garfield, R. E. ; Maul, H. ; Shi, L. ; Maner, W. ; Fittkow, C. ; Olsen, G. ; Saade, George. / Methods and devices for the management of term and preterm labor. In: Annals of the New York Academy of Sciences. 2001 ; Vol. 943. pp. 203-224.
@article{2a4346eb3a384abea98277006ababa25,
title = "Methods and devices for the management of term and preterm labor",
abstract = "In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labor. This step is not easily identifiable with present methods designed to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties that make muscle more excitable and responsive and produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone and nitric oxide appear to have important roles in these processes. The progress of labor can be assessed noninvasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labor. EMG activity also increases substantially during preterm labor in humans and rats and may be predictive of preterm labor. A quantitative method for assessing the cervix is also described. A collascope estimates cervical collagen content from a fluorescent signal generated when collagen crosslinks are illuminated with an excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy and indicate controls and treatments.",
keywords = "Cervix, Collagen, Electromyographic signals, Labor, Myometrium, Nitric oxide, Preterm labor, Progesterone",
author = "Garfield, {R. E.} and H. Maul and L. Shi and W. Maner and C. Fittkow and G. Olsen and George Saade",
year = "2001",
language = "English (US)",
volume = "943",
pages = "203--224",
journal = "Annals of the New York Academy of Sciences",
issn = "0077-8923",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Methods and devices for the management of term and preterm labor

AU - Garfield, R. E.

AU - Maul, H.

AU - Shi, L.

AU - Maner, W.

AU - Fittkow, C.

AU - Olsen, G.

AU - Saade, George

PY - 2001

Y1 - 2001

N2 - In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labor. This step is not easily identifiable with present methods designed to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties that make muscle more excitable and responsive and produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone and nitric oxide appear to have important roles in these processes. The progress of labor can be assessed noninvasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labor. EMG activity also increases substantially during preterm labor in humans and rats and may be predictive of preterm labor. A quantitative method for assessing the cervix is also described. A collascope estimates cervical collagen content from a fluorescent signal generated when collagen crosslinks are illuminated with an excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy and indicate controls and treatments.

AB - In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labor. This step is not easily identifiable with present methods designed to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties that make muscle more excitable and responsive and produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone and nitric oxide appear to have important roles in these processes. The progress of labor can be assessed noninvasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labor. EMG activity also increases substantially during preterm labor in humans and rats and may be predictive of preterm labor. A quantitative method for assessing the cervix is also described. A collascope estimates cervical collagen content from a fluorescent signal generated when collagen crosslinks are illuminated with an excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy and indicate controls and treatments.

KW - Cervix

KW - Collagen

KW - Electromyographic signals

KW - Labor

KW - Myometrium

KW - Nitric oxide

KW - Preterm labor

KW - Progesterone

UR - http://www.scopus.com/inward/record.url?scp=0034784570&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034784570&partnerID=8YFLogxK

M3 - Article

C2 - 11594541

AN - SCOPUS:0034784570

VL - 943

SP - 203

EP - 224

JO - Annals of the New York Academy of Sciences

JF - Annals of the New York Academy of Sciences

SN - 0077-8923

ER -