# A Multi-Modality, Multi-Scale Approach to Understanding Parturition

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2020 · $656,755

## Abstract

Project Summary
The U.S. preterm birth rate is increasing1 and it estimated that if all pregnant women were screened and offered
appropriate available intervention, 95% of PTB would still occur,2 which both indicates that we have exhausted
all currently available options and reflects our poor understanding of the molecular mechanisms underlying this
complex and common problem that affects every society in the world. Recent findings from our labs challenge the
existing paradigm of cervical remodeling in pregnancy. They suggest that perhaps ripening just prior to delivery is
not a simple acceleration or enhancement of the softening that occurs progressively from just after conception
through delivery, but rather is driven by entirely different mechanisms, perhaps by minor ECM components and/or
non-ECM components, some of which are likely still unidentified. We have come to suspect that the collagen
in the ECM reaches a point after which it rearranges no further, despite continued cervical softening and loss
of strength, and that non-ECM components (e.g. blood vessels) play a significant role. These findings hint at
a compelling alternative paradigm for cervical remodeling, but even more, they reveal a large knowledge gap
in our understanding of parturition in general. Our goal is to address this gap, and explore this potential new
paradigm, by constructing patient-specific biomechanical models that delineate the structure-function relationship
of the cervix and other tissues that support the fetus (membranes, uterus), based on specific measurements of
cervical microstructure and maternal anatomy in each individual. We will also explore the contribution of potential
minor extracellular matrix (ECM) and non-ECM informants of cervical remodeling. To this end, we will use our
Rhesus macaque model to longitudinally measure in vivo tissue microstructural properties and maternal anatomy
throughout pregnancy using ultrasound, formulate and validate relationships between ultrasound parameters
and tissue material properties for the cervix in ex vivo gestation-timed samples, explore relationships between
tissue biochemical composition and material properties for the cervix, uterus, and fetal membranes using the ex
vivo samples, and calculate the precise magnitude and regional distribution of tissue stress and stretch for each
macaque using finite element analysis directly informed by her individual microstructural tissue and anatomical
properties. The fundamental model will be flexible enough to eventually accommodate other potential contributors
to cervical remodeling, such as minor ECM factors, or non-ECM factors. To this end, we will build upon the
successes of our current R01 by expanding our Rhesus model to deeply explore the relationship between cervical
microstructure and maternal anatomy, and search for correlations between biomechanical properties of the cervix
and potential influences on cervical remodeling of minor ECM, and non-ECM, components. Ultimately, w...

## Key facts

- **NIH application ID:** 9961626
- **Project number:** 5R01HD072077-08
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Helen Feltovich
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $656,755
- **Award type:** 5
- **Project period:** 2013-01-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9961626

## Citation

> US National Institutes of Health, RePORTER application 9961626, A Multi-Modality, Multi-Scale Approach to Understanding Parturition (5R01HD072077-08). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9961626. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*