Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.
Biophotonics Center, Vanderbilt University, Nashville, Tennessee.
J Biophotonics. 2019 Feb;12(2):e201800138. doi: 10.1002/jbio.201800138. Epub 2018 Oct 29.
Preterm birth (PTB) is the leading cause of neonatal death, however, accurate prediction methods do not exist. Detection of early changes in the cervix, an organ that biochemically remodels to deliver the fetus, has potential to predict PTB risk. Researchers have employed light-based methods to monitor biochemical changes in the cervix during pregnancy, however, these approaches required patients to undergo a speculum examination which many patients find uncomfortable and is not standard practice during prenatal care. Herein, a visually guided optical probe is presented that measures the cervix via introduction by bimanual examination, a procedure that is commonly performed during prenatal visits and labor for tactile monitoring of the cervix. The device incorporates a Raman spectroscopy probe for biochemical monitoring and a camera for visualizing measurement location to ensure it is void of cervical mucus and blood. This probe was tested in 15 patients receiving obstetric and gynecological care, and results acquired with and without a speculum revealed similar spectra, demonstrating that the visually guided probe conserved data quality. Additionally, the majority of patients reported reduced discomfort from the device. In summary, the visual guidance probe successfully measured the cervix while integrating with standard prenatal care, reducing a barrier in clinical translation.
早产（PTB）是新生儿死亡的主要原因，但目前还没有准确的预测方法。检测宫颈的早期变化，宫颈是一个生化重塑以分娩胎儿的器官，具有预测 PTB 风险的潜力。研究人员已经采用基于光的方法来监测怀孕期间宫颈的生化变化，然而，这些方法需要患者进行阴道镜检查，许多患者觉得不舒服，并且在产前护理中不是标准做法。在此，提出了一种视觉引导的光学探头，通过双手检查引入来测量宫颈，该过程通常在产前检查和分娩期间进行，用于宫颈的触觉监测。该设备结合了用于生化监测的拉曼光谱探头和用于可视化测量位置的摄像头，以确保探头没有宫颈粘液和血液。该探头在 15 名接受产科和妇科护理的患者中进行了测试，并且在有无阴道镜的情况下获得的结果显示出相似的光谱，表明视觉引导探头保持了数据质量。此外，大多数患者报告说该设备的不适感降低了。总之，视觉引导探头成功地测量了宫颈，同时与标准的产前护理相结合，减少了临床转化的障碍。
