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Detecting Preterm Labor with Raman Spectroscopy

preterm    Prematurity is the second leading cause of neonatal mortality, leading to a myriad of complications, including delayed development and cerebral palsy. Currently, there is no way to accurately predict when a woman will deliver prematurely, making the prevention and treatment of preterm birth virtually impossible. While there are some populations at risk for preterm labor (patients with a history of previous preterm birth or uterine/cervical abnormalities), over half of all preterm births do not fall into any high-risk category.
    This study seeks to understand, predict, and prevent preterm labor by using Raman spectroscopy to detect biochemical changes in the cervix during pregnancy. Previous results indicate that molecular and cellular changes that occur in precancerous as well as benign tissues yield distinct Raman features. As the cervix is known to undergo an extensive remodeling process in preparation for delivery, it follows that the Raman spectra will reflect these changes and provide insight into the onset of labor. We have acquired in vivo Raman spectra from 68 patients at various time points during their pregnancy, and the results demonstrate significant changes in spectral signatures associated with collagen, actin, lipids and blood. We also observed significant differences in the spectra of normal compared to high BMI patients, and those who have had a previous pregnancy compared to those who have not. Complimentary work in mouse models of pregnancy showed that Raman spectroscopy is sensitive to biochemical changes in the cervices of mice with abnormal delivery timing. A visually-guided Raman spectroscopy probe was recently developed and validated in order to improve the clinical translation of this approach by eliminating the need for a speculum exam.
    Future directions include acquiring in vivo measurement of patients with known risk factors for preterm labor, and evaluation of additional mouse models of preterm labor. Ultimately, the results obtained in mice and in humans will be used to develop an algorithm which predicts a patient's time to delivery based on their Raman spectra. This technology has the potential to improve outcomes for both mother and baby by providing an early indicator of labor onset.



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