title: Assessment of the in vivo biomechanical properties of the human uterine cervix in pregnancy using the aspiration test: a feasibility study.
abstract: OBJECTIVE
  To date no diagnostic tool is yet available to objectively assess the in vivo biomechanical properties of the uterine cervix during gestation.
  
  
  METHODS
  We show the first clinical application of an aspiration device to assess the in vivo biomechanical properties of the cervix in pregnancy with the aim to describe the physiological biomechanical changes throughout gestation in order to eventually detect pregnant women at risk for cervical insufficiency (CI).
  
  
  RESULTS
  Out of 15 aspiration measurements, 12 produced valid results. The stiffness values were in the range between 0.013 and 0.068 bar/mm. The results showed a good reproducibility of the aspiration test. In our previous test series on non-pregnant cervices our repetitive measurements showed a standard deviation of >20% compared to <+/-10% to our data on pregnant cervices. Stiffness values are decreasing with gestational age which indicates a progressive softening of cervical tissue towards the end of pregnancy. Three pregnant women had two subsequent measurements within a time interval of four weeks. Decreasing stiffness values in the range of 20% were recorded.
  
  
  CONCLUSIONS
  This preliminary study on the clinical practicability of aspiration tests showed promising results in terms of reproducibility (reliability) and clinical use (feasibility). Ongoing studies will provide further insights on its usefulness in clinical practice and in the detection of substantial changes of the cervix in pregnancy indicative for threatened preterm birth or cervical insufficiency.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria. margit.holzapfel-bauer@meduni-graz.at
authors.forename: Margit
authors.initials: M
authors.lastname: Bauer
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mazza
authors.forename: Mahmood
authors.initials: M
authors.lastname: Jabareen
authors.forename: Leila
authors.initials: L
authors.lastname: Sultan
authors.forename: Michael
authors.initials: M
authors.lastname: Bajka
authors.forename: Uwe
authors.initials: U
authors.lastname: Lang
authors.forename: Roland
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Holzapfel
mesh_terms: D001696:Biomechanical Phenomena; D001703:Biophysics / Q000295:instrumentation; D002584:Cervix Uteri / Q000502:physiology*; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D004548:Elasticity; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis / Q000517:prevention & control; D015203:Reproducibility of Results; D002581:Uterine Cervical Incompetence / Q000175:diagnosis