In vivo Raman spectroscopy monitors cervical change during labor

• Published in: American journal of obstetrics and gynecology 2022-08, Vol.227 (2), p.275.e1-275.e14
• Main Authors: Masson, Laura E., O’Brien, Christine M., Gautam, Rekha, Thomas, Giju, Slaughter, James C., Goldberg, Mack, Bennett, Kelly, Herington, Jennifer, Reese, Jeff, Elsamadicy, Emad, Newton, J. Michael, Mahadevan-Jansen, Anita
• Format: Article
• Language: English
• Subjects: biochemical; Cervical Ripening; Cervix Uteri - diagnostic imaging; Collagen - metabolism; Extracellular Matrix Proteins - metabolism; Female; Humans; induction; labor management; Lipids; optical; Pregnancy; preterm labor; spectroscopy; Spectrum Analysis, Raman - methods; technology
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2022.02.019

Biochemical cervical change during labor is not well understood, in part, because of a dearth of technologies capable of safely probing the pregnant cervix in vivo. The need for such a technology is 2-fold: (1) to gain a mechanistic understanding of the cervical ripening and dilation process and (2) to provide an objective method for evaluating the cervical state to guide clinical decision-making. Raman spectroscopy demonstrates the potential to meet this need, as it is a noninvasive optical technique that can sensitively detect alterations in tissue components, such as extracellular matrix proteins, lipids, nucleic acids, and blood, which have been previously established to change during the cervical remodeling process. We sought to demonstrate that Raman spectroscopy can longitudinally monitor biochemical changes in the laboring cervix to identify spectral markers of impending parturition. Overall, 30 pregnant participants undergoing either spontaneous or induced labor were recruited. The Raman spectra were acquired in vivo at 4-hour intervals throughout labor until rupture of membranes using a Raman system with a fiber-optic probe. Linear mixed-effects models were used to determine significant (P