Impact of cervix geometry and stitch material on success of cerclage procedure

Cervical insufficiency is a medical condition during pregnancy in which the uterine cervix softens and begins to dilate before reaching full term. It is the most common cause of second trimester pregnancy loss. One clinical technique used to treat cervical insufficiency is the cervical cerclage. There are conflicting findings on the efficacy of a cerclage. The purpose of this investigation is to examine the mechanical limitations of a cervical cerclage in different presentations of cervical insufficiency. Generalized synthetic models of the cervix are created using ultrasound images collected by clinical collaborators and fabricated with silicon to imitate physiological properties of the cervix. Because precise data do not exist on the material properties of the softened cervix, we quantified the qualitative assessment of trained obstetricians. Physicians stitch the synthetic cervixes and pressure transducers record the maximum force on the stitch before rupture. The cervical geometry (e.g. how wide the cervix has dilated when the stitch is performed) and stitch material are varied to investigate their impact on the success of the cerclage stitch. The results of this study will provide insight into the most effective clinical interventions and the mechanism of their success.