In-vivo stretch of term human fetal membranes |
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| Affiliation: | 1. Department of Bioengineering, Swanson School of Engineering, School of Medicine, University of Pittsburgh, Pittsburgh PA, USA;2. Department of Radiology, MetroHealth Medical Center and Case Western Reserve University, USA;3. Department of Biomedical Engineering, Case Western Reserve University, USA;4. Department of Pediatrics, MetroHealth Medical Center and Case Western Reserve University, USA;5. Department of Reproductive Biology, MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH, USA;6. Department of Biomedical Engineering and the Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712-0027, USA;1. Department of Pediatrics – Division of Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands;2. Institute of Biomedicine, Faculty of Medicine, Catholic University of Santiago de Guayaquil, Guayaquil, Ecuador;3. Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador;4. Department of Neuropsychology – Division Neuroscience, Maastricht University, School of Mental Health and Neuroscience (MHeNS), Maastricht, The Netherlands;5. Child Neurology, Maastricht University Medical Center, Maastricht, The Netherlands;1. Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, UK;2. Department of Obstetrics and Gynaecology, University Medical Centre of Groningen, University of Groningen, The Netherlands;3. Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK;4. Department of Engineering, University of Cambridge, Cambridge, UK;1. Center for Neuroscience Research, Children''s Research Institute, Children''s National Medical Center, Washington, DC 20010, USA;2. Institute for Biomedical Sciences, The George Washington University, Washington, DC 20052, USA;1. Institute for Women''s Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK;2. Institute of Bioengineering, School of Engineering and Material Science, Queen Mary University of London, Mile End Road, London E1 4NS, UK;3. Department of Cell and Developmental Biology, UCL, Gower Street, London WC1E 6BT, UK;4. Lee Kong Chian School of Medicine, Nanyang Technological University, 11, Mandalay Road, Singapore;5. Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK;1. Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine & Perinatal Research, Galveston, TX, USA;2. Department of Neuroscience & Cell Biology, Center for Biomedical Engineering, The University of Texas Medical Branch at Galveston, Galveston, TX, USA;3. Department of Obstetrics & Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czechia Republic;4. Department of Obstetrics & Gynecology, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia |
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| Abstract: | IntroductionFetal membranes (FM) usually fail prior to delivery during term labor, but occasionally fail at preterm gestation, precipitating preterm birth. To understand the FM biomechanical properties underlying these events, study of the baseline in-vivo stretch experienced by the FM is required. This study's objective was to utilize high resolution MRI imaging to determine in-vivo FM stretch.MethodsEight pregnant women (38.4 ± 0.4wks) underwent abdominal-pelvic MRI prior to (2.88 ± 0.83d) caesarean delivery. Software was utilized to determine the total FM in-vivo surface area (SA) and that of its components: placental disc and reflected FM. At delivery, the SA of the disc and FM in the relaxed state were measured. In-vivo (stretched) to delivered SA ratios were calculated. FM fragments were then biaxially stretched to determine the force required to re-stretch the FM back to in-vivo SA.ResultsTotal FM SA, in-vivo vs delivered, was 2135.51 ± 108.47 cm2 vs 842.59 ± 35.86 cm2; reflected FM was 1778.42 ± 107.39 cm2 vs 545.41 ± 22.90 cm2, and disc was 357.10 ± 28.08 cm2 vs 297.18 ± 22.14 cm2. The ratio (in-vivo to in-vitro SA) of reflected FM was 3.26 ± 0.11 and disc was 1.22 ± 0.10. Reflected FM re-stretched to in-vivo SA generated a tension of 72.26 N/m, corresponding to approximate pressure of 15.4 mmHg. FM rupture occurred at 295.08 ± 31.73 N/m corresponding to approximate pressure of 34 mmHg. Physiological SA was 70% of that at rupture.DiscussionFM are significantly distended in-vivo. FM collagen fibers were rapidly recruited once loaded and functioned near the failure state during in-vitro testing, suggesting that, in-vivo, minimal additional (beyond physiological) stretch may facilitate rapid, catastrophic failure. |
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| Keywords: | Fetal membranes Surface area MRI Deformation Intrauterine stretch Biomechanics |
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