The problems associated with labor during pregnancy are among the most important health issues facing physicians. Understanding the role of the uterus and cervix in labor and developing methods to control their function is essential to solving problems relating to labor. At the moment, only crude, inaccurate and subjective methods are used to assess changes in the uterus and cervix that occur in preparation for or during labor. In the past several years, the applicant and his colleagues have developed noninvasive methods to quantitatively evaluate the uterus and cervix based respectively on recording of uterine electrical signals from the abdominal surface (uterine EMG) and measurement of light- induced cervical collagen fluorescence (LIF) with an optical device (Collascope). The methods are rapid and allow assessment of uterine contractility and cervical ripening. Preliminary studies in rats and humans indicate that uterine and cervical function can be successfully monitored during pregnancy using these approaches and that these techniques might be used in a variety of conditions associated with labor to better define management. This application is for funds to extend the initial studies. Four studies are proposed using abdominal EMB recordings and cervical LIF. A competent team of investigators and staff has been assembled to fulfill the needs and goals of this proposal. The specific hypotheses are that LIF and abdominal EMG recordings can be used to: 1) differentiate between true and false labor; 2) predict the onset of labor; 3) monitor patients during tocolysis or induction of labor.
The specific aims are to use EMG activity and LIF to determine if they are helpful to: 1) assess patients in true versus false labor; 2) monitor antepartum patients longitudinally; 3) examine the effectiveness of tocolytics or induction. The potential benefits of the proposed instrumentation and methods include reducing the rate of preterm delivery, improving maternal and perinatal outcome, monitoring treatment, decreasing cesarean section rate and improving research methods to understand uterine and cervical function.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD037480-05
Application #
6628898
Study Section
Human Embryology and Development Subcommittee 1 (HED)
Program Officer
Ilekis, John V
Project Start
1999-02-01
Project End
2004-10-31
Budget Start
2003-02-01
Budget End
2004-10-31
Support Year
5
Fiscal Year
2003
Total Cost
$305,584
Indirect Cost
Name
University of Texas Medical Br Galveston
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
800771149
City
Galveston
State
TX
Country
United States
Zip Code
77555
Lucovnik, Miha; Kuon, Ruben J; Chambliss, Linda R et al. (2011) Progestin treatment for the prevention of preterm birth. Acta Obstet Gynecol Scand 90:1057-69
Lucovnik, Miha; Maner, William L; Chambliss, Linda R et al. (2011) Noninvasive uterine electromyography for prediction of preterm delivery. Am J Obstet Gynecol 204:228.e1-10
Kuon, Ruben J; Shi, Shao-Qing; Maul, Holger et al. (2011) A novel optical method to assess cervical changes during pregnancy and use to evaluate the effects of progestins on term and preterm labor. Am J Obstet Gynecol 205:82.e15-20
Lucovnik, Miha; Kuon, Ruben J; Chambliss, Linda R et al. (2011) Use of uterine electromyography to diagnose term and preterm labor. Acta Obstet Gynecol Scand 90:150-7
Kuon, Ruben J; Shi, Shao-Qing; Maul, Holger et al. (2010) Pharmacologic actions of progestins to inhibit cervical ripening and prevent delivery depend on their properties, the route of administration, and the vehicle. Am J Obstet Gynecol 202:455.e1-9
Ku, Chun-Ying; Murtazina, Dilyara A; Kim, Yoon-Sun et al. (2010) Changes in rat myometrial plasma membrane protein kinase A are confined to parturition. Reprod Sci 17:696-704
Schlembach, Dietmar; Mackay, Lynette; Shi, Leili et al. (2009) Cervical ripening and insufficiency: from biochemical and molecular studies to in vivo clinical examination. Eur J Obstet Gynecol Reprod Biol 144 Suppl 1:S70-6
Schlembach, Dietmar; Maner, Wiliam L; Garfield, Robert E et al. (2009) Monitoring the progress of pregnancy and labor using electromyography. Eur J Obstet Gynecol Reprod Biol 144 Suppl 1:S33-9
Shi, Shao-Qing; Maner, William L; Mackay, Lynette B et al. (2008) Identification of term and preterm labor in rats using artificial neural networks on uterine electromyography signals. Am J Obstet Gynecol 198:235.e1-4
Garfield, Robert E; Maner, William L (2007) Physiology and electrical activity of uterine contractions. Semin Cell Dev Biol 18:289-95

Showing the most recent 10 out of 16 publications