Zhang Yali, Kaplan David, House Michael D
Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA.
Department of Biomedical Engineering, Tufts University, Medford, MA, USA.
Curr Opin Biomed Eng. 2022 Jun;22. doi: 10.1016/j.cobme.2022.100385. Epub 2022 Mar 28.
Cervical insufficiency is a significant obstetrical complication that causes preterm birth. The current treatment of cervical insufficiency is cerclage surgery. A cerclage is a suture that is placed around the cervix to provide compression support. The load bearing portion of the cervix is the stroma, which is composed of collagen-rich extracellular matrix. A remarkable feature of the cervix is progressive softening throughout gestation. The biochemical mechanisms of cervical softening, however, are poorly understood. In this narrative review, we discuss our approach to using tissue engineering techniques to study cervical function in pregnancy. A brief review of the clinical significance of the cervix in pregnancy is presented. The development of a tissue engineering model for studying cervical remodeling is discussed. We also discuss an engineered injectable hydrogel as an alternate treatment for cervical dysfunction. We advocate for a bioengineering approach to study cervical dysfunction in pregnancy.
宫颈机能不全是导致早产的一种重要产科并发症。目前宫颈机能不全的治疗方法是宫颈环扎术。宫颈环扎术是一种围绕宫颈放置的缝线，以提供压迫支撑。宫颈的承重部分是基质，它由富含胶原蛋白的细胞外基质组成。宫颈的一个显著特征是在整个妊娠期会逐渐变软。然而，宫颈变软的生化机制尚不清楚。在这篇叙述性综述中，我们讨论了使用组织工程技术研究妊娠期宫颈功能的方法。本文简要回顾了宫颈在妊娠中的临床意义。讨论了用于研究宫颈重塑的组织工程模型的开发。我们还讨论了一种工程化可注射水凝胶作为宫颈功能障碍的替代治疗方法。我们提倡采用生物工程方法来研究妊娠期宫颈功能障碍。
