Biomechanics of cervical function in pregnancy : case of cervical insufficiency

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2007.

Bibliographic Details
Main Author: Paskaleva, Anastassia
Other Authors: Simona Socrate.
Format: Thesis
Language:eng
Published: Massachusetts Institute of Technology 2008
Subjects:
Online Access:http://hdl.handle.net/1721.1/42287
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author Paskaleva, Anastassia
author2 Simona Socrate.
author_facet Simona Socrate.
Paskaleva, Anastassia
author_sort Paskaleva, Anastassia
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description Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2007.
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spelling mit-1721.1/422872019-04-11T03:49:28Z Biomechanics of cervical function in pregnancy : case of cervical insufficiency Paskaleva, Anastassia Simona Socrate. Massachusetts Institute of Technology. Dept. of Mechanical Engineering. Massachusetts Institute of Technology. Dept. of Mechanical Engineering. Mechanical Engineering. Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2007. Includes bibliographical references (p. 203-212). The uterine cervix is a passive organ in the female body. Its normal function in pregnancy is to stay firm and closed for the duration of the gestation. At term, under the action of coordinated contractions from the myometrium the cervix dilates sufficiently to allow for the delivery of the fetus. Cervical insufficiency refers to a condition in which the cervix dilates asymptomatically and painlessly in the absence of contractions from the uterine smooth muscle and results in a spontaneous pregnancy loss between the second and third trimester of pregnancy. An elusive and often misdiagnosed condition, cervical insufficiency accounts for a significant percentage of extremely premature deliveries with high incidence of infant mortality and morbidity. Accurate diagnostic criteria and treatment guidelines for this condition are not established and remain a clinical and research challenge. In an attempt to better understand the biomechanics of cervical insufficiency, a fully three-dimensional constitutive model for the large strain, time dependent mechanical behavior of the cervical stroma is proposed. The constitutive model is implemented numerically and integrated with a three dimensional solid model of the lower pelvic region of a pregnant patient into a finite element framework. The resulting finite element model provides a tool to study the effects of different clinical features on the biomechanics of the pregnant cervix and uterus, and allows to investigate the conditions that lead to a premature dilation in the case of cervical insufficiency. New findings on the mechanical behavior of the stroma emphasize the complexity of the stress-strain and volume change behavior of the stroma as well as the intricate correlation between the two. The challenges involved in prescribing a constitutive behavior for the cervical tissue include characteristics such as nonlinearity, viscoelasticity, anisotropy, inhomogeneity and preconditioning. (cont.) Additionally, the tissue behavior exhibits marked differences in tension and compression with associated stress levels differing more than an order of magnitude between the different modes of deformation. A new constitutive framework capable of capturing the complexity of tissue behavior is proposed and material properties in compression are obtained by fitting finite element model simulations to experimental data. The model is further extended to incorporate effects of anisotropy of the cervical stroma. Suitable choice of the levels of tissue anisotropy is shown to accommodate the differences between the mechanical behavior in tension and compression. by Anastassia P. Paskaleva. Ph.D. 2008-09-03T15:13:25Z 2008-09-03T15:13:25Z 2007 2007 Thesis http://hdl.handle.net/1721.1/42287 232156843 eng M.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission. http://dspace.mit.edu/handle/1721.1/7582 212 p. application/pdf Massachusetts Institute of Technology
spellingShingle Mechanical Engineering.
Paskaleva, Anastassia
Biomechanics of cervical function in pregnancy : case of cervical insufficiency
title Biomechanics of cervical function in pregnancy : case of cervical insufficiency
title_full Biomechanics of cervical function in pregnancy : case of cervical insufficiency
title_fullStr Biomechanics of cervical function in pregnancy : case of cervical insufficiency
title_full_unstemmed Biomechanics of cervical function in pregnancy : case of cervical insufficiency
title_short Biomechanics of cervical function in pregnancy : case of cervical insufficiency
title_sort biomechanics of cervical function in pregnancy case of cervical insufficiency
topic Mechanical Engineering.
url http://hdl.handle.net/1721.1/42287
work_keys_str_mv AT paskalevaanastassia biomechanicsofcervicalfunctioninpregnancycaseofcervicalinsufficiency