Fatigue loading and volumetric microscopy demonstrate changes to the mouse cervix throughout and after pregnancy

The cervix plays important mechanical roles in pregnancy and regulating the timing of parturition. Dysfunction of the cervix is implicated in disorders of parturition including spontaneous preterm birth, failed induction of labor and post term pregnancies. To address these disorders, it is imperative to first understand the function of the cervix throughout a normal pregnancy. However, current knowledge on the response of the cervix to mechanical fatigue and the underlying microstructural changes throughout a pregnancy is lacking.

In this study, mechanical fatigue properties were measured at different stages of pregnancy using uniaxial fatigue testing that simulated circumferential hoop stresses in the cervix. Collagen microstructure was quantified using second harmonic generation imaging and three-dimensional orientation analysis.

The stiffness and modulus of the cervix during fatigue testing were dramatically reduced in all stages of pregnancy, and pregnant samples experienced greater peak strain before failure. All mechanical properties recovered postpartum despite persistent changes in cervix size. Microstructural analysis demonstrated increased local collagen alignment in postpartum samples, which may indicate a mechanism that serves to improve material properties after childbirth.

Altogether, conclusions from this study enhance our understanding of how properties of the cervix change with pregnancy and lay the foundation for future work investigating how alterations from this healthy function can lead to spontaneous preterm birth and other reproductive complications.