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Dynamics of T2* and deformation in the placenta and myometrium during pre-labour contractions

Hutter, Jana; Kohli, Vikram; Dellschaft, Neele; Uus, Alena; Story, Lisa; Steinweg, Johannes K.; Gowland, Penny; Hajnal, Joseph V.; Rutherford, Mary A.

Authors

Jana Hutter

Vikram Kohli

Alena Uus

Lisa Story

Johannes K. Steinweg

Joseph V. Hajnal

Mary A. Rutherford



Abstract

Pre-labour uterine contractions, occurring throughout pregnancy, are an important phenomenon involving the placenta in addition to the myometrium. They alter the uterine environment and thus potentially the blood supply to the fetus and may thus provide crucial insights into the processes of labour. Assessment in-vivo is however restricted due to their unpredictability and the inaccessible nature of the utero-placental compartment. While clinical cardiotocography (CTG) only allows global, pressure-based assessment, functional magnetic resonance imaging (MRI) provides an opportunity to study contractile activity and its effects on the placenta and the fetus in-vivo. This study aims to provide both descriptive and quantitative structural and functional MR assessments of pre-labour contractions in the human uterus. A total of 226 MRI scans (18–41weeks gestation) from ongoing research studies were analysed, focusing on free-breathing dynamic quantitative whole uterus dynamic T2* maps. These provide an indirect measure of tissue properties such as oxygenation. 22 contractile events were noted visually and both descriptive and quantitative analysis of the myometrial and placental changes including volumetric and T2* variations were undertaken. Processing and analysis was successfully performed, qualitative analysis shows distinct and highly dynamic contraction related characteristics including; alterations in the thickness of the low T2* in the placental bed and other myometrial areas, high intensity vessel-like structures in the myometrium, low-intensity vessel structures within the placental parenchyma and close to the chorionic plate. Quantitative evaluation shows a significant negative correlation between T2* in both contractile and not-contractile regions with gestational age (p < 0.05) as well as a significant reduction in T2* during contractions. The T2* values in the myometrium were however not correlated to gestational age (p > 0.5). The quantitative and qualitative description of uterine pre-labour contractions including dynamic changes and key characteristics aims to contribute to the sparsely available in-vivo information and to provide an in-vivo tool to study this important phenomenon. Further work is required to analyse the origins of these subclinical contractions, their effects in high-risk pregnancies and their ability to determine the likelihood of a successful labour. Assessing T2* distribution as a marker for placental oxygenation could thus potentially complement clinically used cardiotocography measurements in the future.

Citation

Hutter, J., Kohli, V., Dellschaft, N., Uus, A., Story, L., Steinweg, J. K., …Rutherford, M. A. (2022). Dynamics of T2* and deformation in the placenta and myometrium during pre-labour contractions. Scientific Reports, 12(1), Article 18542. https://doi.org/10.1038/s41598-022-22008-3

Journal Article Type Article
Acceptance Date Oct 7, 2022
Online Publication Date Nov 3, 2022
Publication Date Nov 3, 2022
Deposit Date Jan 10, 2023
Publicly Available Date Mar 28, 2024
Journal Scientific Reports
Electronic ISSN 2045-2322
Peer Reviewed Peer Reviewed
Volume 12
Issue 1
Article Number 18542
DOI https://doi.org/10.1038/s41598-022-22008-3
Public URL https://nottingham-repository.worktribe.com/output/13449329
Publisher URL https://www.nature.com/articles/s41598-022-22008-3

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Dynamics of T2* and deformation in the placenta and myometrium during pre-labour contractions (2 Mb)
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Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/

Copyright Statement
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.




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