Mechanical assessment of cervical remodelling in pregnancy: insight from a synthetic model

During the gestation and the cervical remodelling, several changes occur progressively in the structure of the tissue. An increase in the hydration, disorganisation of collagen network and decrease in elasticity can be observed. The collagen structure disorganisation is particularly complex: collagen fibres turn thicker and more wavy as the gestation progresses in a transition from relatively straight fibres to wavy fibres, while pores between collagen fibres become larger and separated. Shear wave elastography is a promising but not yet fully understood tool to assess these structural changes and the cervix׳s ability to dilate. To this end, a numerical histo-mechanical model is proposed in the present study, which aims at linking variations in the microscopic histo-biomechanical processes with shear wave propagation characteristics. Parametric simulations are carried out for a broad range of mechanical and geometrical parameters. Results show a direct relationship between the histological and morphological changes during pregnancy and the viscoelastic behaviour of the tissue.