Finite Element Analysis (FEA) – Pregnancy Biomechanics

The Myers Soft Tissue lab is currently building an engineering analysis workflow from a clinical patient examination to FEA simulation for the quantification and visualization of the mechanical loads in human pregnancy. We believe this predictive engineering analysis will provide better clinical risk stratification of patients such that women at the lowest risk for preterm birth can avoid costly and potentially detrimental interventions. For those at high-risk, we hope to guide the development of patient-specific therapeutic interventions based on their precise mechanical loading environment.

Ultrasound-based Parametric Model of Pregnancy
We have scripted a novel solid modeling parametric routine to generate a meshed solid model of the pregnant abdomen based on maternal ultrasonic data. To demonstrate the flexibility of this parametric model, we have evaluated the sensitivity of tissue stress and stretch to cervical tissue properties and geometry [Westervelt et al.]. Geometric variations include anterior uterocervical angle, cervical length, and posterior cervical offset from the uterine axis. Results indicate both the geometric and material properties of the cervix influence the distribution and magnitude of tissue stretch, where cervical tissue material properties have the largest influence. 

Clinical Studies

This engineering workflow is currently being developed and validated with two clinically-based studies at CUMC:

1. Characterizing Low-Risk Pregnancies

We are currently measuring time-course maternal and fetal anatomy and cervical tissue properties throughout gestation. Using these measurements we are building patient-specific FEA models to establish tissue stress and stretch profiles throughout human pregnancy.

2. Mechanical Function of Pessary

We are participating in an ancillary study to the NICHD Maternal-Fetal Medicine Units (MFMU) Network TOPS trial, evaluating the mechanical benefit of the pessary for singleton pregnancies. Our study will build FEA models of subjects with and without pessary to calculate and visualize the pattern and magnitude of cervical stress and stretch. We will evaluate birthing outcomes as a function of mechanical loading environment.

Soft Tissue Material Characterization

The Myers Soft Tissue lab is currently characterizing the material behavior of the cervix, uterus, and fetal membranes, accounting for the complex deformation mechanisms (e.g. elastic, viscous, and damage) and growth and remodeling behavior of its underlying hierarchal biological constituents. Doing so, we aim to calculate tissue stress and stretch profiles throughout human pregnancy to discern the material failure mechanisms related to preterm birth.

Funding Agencies:

National Institutes of Health – NICHD
National Science Foundation – CMMI
Columbia University Irving Institute for Clinical and Translational Medicine
March of Dimes Prematurity Research Center – University of Pennsylvania