Tissue Engineering for Cervical Function in Pregnancy

Cervical insufficiency is a significant obstetrical complication that causes preterm birth. The current treatment of cervical insufficiency is cerclage surgery. A cerclage is a suture that is placed around the cervix to provide compression support. The load bearing portion of the cervix is the stroma, which is composed of collagen-rich extracellular matrix. A remarkable feature of the cervix is progressive softening throughout gestation. The biochemical mechanisms of cervical softening, however, are poorly understood. In this narrative review, we discuss our approach to using tissue engineering techniques to study cervical function in pregnancy. A brief review of the clinical significance of the cervix in pregnancy is presented. The development of a tissue engineering model for studying cervical remodeling is discussed. We also discuss an engineered injectable hydrogel as an alternate treatment for cervical dysfunction. We advocate for a bioengineering approach to study cervical dysfunction in pregnancy.