Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes

Uterine injury from Cesarean sections (C-sections) and other procedures (dilation and curettage, myomectomies, etc.) can lead to several morbidities in subsequent pregnancies, including placenta previa, placenta accreta spectrum (PAS), Cesarean scar pregnancy, and uterine rupture. C-sections account for approximately 30% of deliveries in the US, with rates projected to rise. Therefore, a deeper understanding of the mechanisms by which injury-associated pregnancy disorders arise and a platform for testing possible interventions are essential. To achieve these objectives, there is a critical need for animal models of uterine injury, particularly those that address the impact of injury on subsequent in utero outcomes. This protocol describes a novel surgical procedure for a model of mechanically induced uterine injury in the laboratory mouse (Mus musculus). Steps taken in preparation for surgery, induction of the uterine injury itself, and post-surgical recovery procedures are demonstrated. Additional information is provided regarding the downstream dissection of both non-pregnant and pregnant mice. Overall, by detailing a set of procedures for inducing uterine injury in an in vivo model, this protocol presents a tractable method for elucidating the molecular and cellular events of uterine wound healing and its effects on subsequent pregnancy.