Preterm birth can cause severe health problems or even be fatal for the fetus, and, also imposes significant financial burdens on health care systems. Early and reliable diagnosis is essential to the development of successful interventions to prevent preterm delivery and improve outcome. In terms of physiology, the uterus is a complex organ, and at this time, our knowledge of the physiological mechanism of the onset and propagation of uterine contractions of labor remains incomplete. The uterus is normally able to accomplish the remarkable task of maintaining an environment which suppresses uterine contractile activity and is conducive to fetal development. At term gestation however, it initiates and coordinates the individual firing of myometrial cells to produce organized contractions resulting in expulsion of the fetus. For poorly understood reasons, the onset of this coordinated activity can occur prior to term gestation with consequential birth of a premature infant. It is evident that the uterus undergoes electrophysiological changes leading to organized uterine contractions, thus providing the basis for the development of a methodology to accurately predict the onset of active labor. This proposal is a development of the combined efforts of a multidisciplinary team of members of the University of Arkansas for Medical Sciences (UAMS), University of Arkansas at Little Rock and Washington University St. Louis. All of these researchers have specialized knowledge in diverse fields of obstetrics, applied sciences and engineering relevant to the development of a synergetic environment. The need for such an effort is based on lack of tools in field of obstetrics for objective diagnosis of labor. UAMS has the world's first biomagnetic sensing system built specifically for fetal-maternal assessment. The SARA (SQUID Array for Reproductive Assessment) system consists of 151 primary superconducting sensors which detect biomagnetic fields generated in the body by various bioelectric sources including uterine muscles. The term "SQUID" is an acronym for "Superconducting Quantum Interference Device." The SARA system is completely non-invasive and permits the investigation of fetal and maternal parameters from early gestation until delivery. We have shown that SARA is capable of recording electrical activity of the uterine smooth muscles that can provide an electrophysiological signature of onset of labor. To transform it into a clinical tool we need to investigate how therapeutic interventions will alter te labor process. In order to accomplish this we propose to develop a multiscale forward electromagnetic model of contractile activity during pregnancy taking into account electrophysiological and anatomical knowledge. By combining macroscopic recordings with multi-scale modeling approach, we believe the model will not only provide a link to observed uterine electrophysiological signals but also provide useful therapeutic information for the clinical management of pregnancy.

Public Health Relevance

An objective technique to predict the true onset of labor in term and preterm patients would be of great clinical benefit to aid in management of pregnancies by decreasing the cost of needless hospital admissions, and providing a true diagnosis early in the onset of preterm labor so that treatment could be initiated more expediently and effectively.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
1R01EB016567-01A1
Application #
8629972
Study Section
Special Emphasis Panel (ZRG1-SBIB-V (82))
Program Officer
Peng, Grace
Project Start
2013-09-20
Project End
2015-08-31
Budget Start
2013-09-20
Budget End
2014-08-31
Support Year
1
Fiscal Year
2013
Total Cost
$280,000
Indirect Cost
$65,630
Name
University of Arkansas for Medical Sciences
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
122452563
City
Little Rock
State
AR
Country
United States
Zip Code
72205