Investigation of cervical remodeling during pregnancy with in vivo Raman spectroscopy

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.