# A Novel Device for Cervical Insufficiency in Pregnant Women

> **NIH NIH R44** · CX THERAPEUTICS, INC · 2024 · $1,141,527

## Abstract

Abstract
Cervical insufficiency is a severe complication of pregnancy that leads to preterm birth. Preterm birth is a
significant cause of morbidity and mortality in newborns infants and can cause long-term disabilities during
childhood. Healthcare spending for preterm infants is expensive, with infants born before 37 weeks costing an
average of $76,000 in the first six months after birth. Cervical insufficiency is caused by structural failure of the
cervix. In normal pregnancy, the cervix is strong enough to stay closed throughout pregnancy. However, in cases
of cervical insufficiency, the cervix is unable to retain the pregnancy during fetal growth. The cervix dilates in the
absence of uterine contractions, which leads to preterm birth. The mainstay of treatment is cervical cerclage, a
surgical procedure that uses a suture to compress the cervix. Cervical compression prevents preterm dilation
and maintains a sterile barrier between the fetal and vaginal environments. Approximately 15,000 cerclage
surgeries are performed each year in the U.S. (0.4% of pregnancies). Although cerclage is well-integrated into
clinical practice, the efficacy of cerclage is limited, and adverse effects occur. Cx Therapeutics is developing the
Cx Device, a medical device to improve the efficacy of cerclage and to decrease its adverse effects. The Cx
Device is composed of four silicone plates arranged circumferentially around the cervix. A suture is threaded
through each plate and alternately passes into the cervix for placement. Upon tightening, the suture compresses
the plates, which in turn compress the tissue, effectively applying compression more evenly to the cervix. More
uniform application of compression decreases stress concentrations in the tissue. Previous work has
demonstrated the Cx Device has a higher load carrying capability compared to cerclage. The Cx Device also
lengthens the cervix compared to cerclage, suggesting the Cx Device will lead to improved efficacy in vivo. The
current Direct to Phase II proposal will continue to advance this novel device for cervical insufficiency closer to
commercialization by completing engineering validation and conducting a limited first-in-human study. Cx
Therapeutics brings together a highly qualified team with expertise in medical device design, product
development, regulatory affairs, and high-risk obstetrics, to achieve the following Aims. Aim 1 will finalize the
design of the device and complete engineering verification. Engineering activities will be informed by
computational modeling and usability testing with physicians. Experiments in Aim 2 will validate the Cx Device
through compression measurements on ex vivo human tissue and assess its usability in the operating room.
Experiments in Aim 3 will assess biocompatibility by performing studies to determine in vitro cytotoxicity and
evaluate long-term effects in a pig model of pregnancy. At the end of Phase II, Cx Therapeutics will have
developed a production eq...

## Key facts

- **NIH application ID:** 11006391
- **Project number:** 1R44HD116620-01
- **Recipient organization:** CX THERAPEUTICS, INC
- **Principal Investigator:** Michael Douglas House
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,141,527
- **Award type:** 1
- **Project period:** 2024-09-17 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11006391

## Citation

> US National Institutes of Health, RePORTER application 11006391, A Novel Device for Cervical Insufficiency in Pregnant Women (1R44HD116620-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/11006391. Licensed CC0.

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