{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:06:00Z","timestamp":1780344360606,"version":"3.54.1"},"reference-count":52,"publisher":"ASME International","issue":"2","content-domain":{"domain":["asmedigitalcollection.asme.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,2,1]]},"abstract":"<jats:p>The mechanical integrity of the uterine cervix is critical for a pregnancy to successfully reach full term. It must be strong to retain the fetus throughout gestation and then undergo a remodeling and softening process before labor for delivery of the fetus. It is believed that cervical insufficiency (CI), a condition in pregnancy resulting in preterm birth (PTB), is related to a cervix with compromised mechanical strength which cannot resist deformation caused by external forces generated by the growing fetus. Such PTBs are responsible for infant developmental problems and in severe cases infant mortality. To understand the etiologies of CI, our overall research goal is to investigate the mechanical behavior of the cervix. Permeability is a mechanical property of hydrated collagenous tissues that dictates the time-dependent response of the tissue to mechanical loading. The goal of this study was to design a novel soft tissue permeability testing device and to present direct hydraulic permeability measurements of excised nonpregnant (NP) and pregnant (PG) human cervical tissue from women with different obstetric histories. Results of hydraulic permeability testing indicate repeatability for specimens from single patients, with an order of magnitude separating the NP and PG group means (2.1\u2003\u00b1\u20031.4\u00d710-14 and 3.2\u2003\u00b1\u20034.8\u00d710-13m4\/N\u00b7s, respectively), and large variability within the NP and PG sample groups. Differences were found between samples with similar obstetric histories, supporting the view that medical history may not be a good predictor of permeability (and therefore mechanical behavior) and highlighting the need for patient-specific measurements of cervical mechanical properties. The permeability measurements from this study will be used in future work to model the constitutive material behavior of cervical tissue and to develop in vivo diagnostic tools to stage the progression of labor.<\/jats:p>","DOI":"10.1115\/1.4023380","type":"journal-article","created":{"date-parts":[[2013,1,18]],"date-time":"2013-01-18T23:20:04Z","timestamp":1358551204000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":25,"title":["Direct Measurement of the Permeability of Human Cervical Tissue"],"prefix":"10.1115","volume":"135","author":[{"given":"Michael","family":"Fernandez","sequence":"first","affiliation":[{"name":"Graduate Research Assistant Deptarment of Mechanical Engineering, Columbia University, New York, NY 10027 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Vink","sequence":"additional","affiliation":[{"name":"Assistant Clinical Professor Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Graduate Research Assistant Department of Mechanical Engineering, Columbia University, New York, NY 10027 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Wapner","sequence":"additional","affiliation":[{"name":"Vice Chairman for Research Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin M.","family":"Myers","sequence":"additional","affiliation":[{"name":"Assistant Professor Department of Mechanical Engineering, Columbia University, New York, NY 10027 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2013,2,7]]},"reference":[{"key":"2019100317053967500_B1","volume-title":"March of Dimes, PMNCH, Save the Children, WHO. Born Too Soon: The Global Action Report on Preterm Birth","year":"2012"},{"key":"2019100317053967500_B2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.2471\/BLT.08.062554","article-title":"The Worldwide Incidence of Preterm Birth: A Systematic Review of Maternal Mortality and Morbidity","volume":"88","year":"2010","journal-title":"Bull. World Health Organ."},{"issue":"7","key":"2019100317053967500_B3","first-page":"1","article-title":"National Vital Statistics Reports: Births: Final Data for 2006, CDC\/National Center for Health Statistics","volume":"57","author":"National Center for Health","year":"2006"},{"issue":"9606","key":"2019100317053967500_B4","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(08)60074-4","article-title":"Epidemiology and Causes of Preterm Birth","volume":"371","year":"2008","journal-title":"Lancet"},{"issue":"20","key":"2019100317053967500_B5","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1056\/NEJMoa067187","article-title":"Glucose Regulation in Young Adults With Very Low Birth Weight","volume":"356","year":"2007","journal-title":"N. Engl J. Med."},{"issue":"4 Pt 1","key":"2019100317053967500_B6","first-page":"1097","article-title":"Cervical Competence as a Continuum: A Study of Ultrasonographic Cervical Length and Obstetric Performance","volume":"172","year":"1995","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"2","key":"2019100317053967500_B7","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.acra.2006.11.010","article-title":"Real-Time Sonoelastography of the Cervix: Tissue Elasticity of the Normal and Abnormal Cervix","volume":"14","year":"2007","journal-title":"Acad. Radiol."},{"issue":"8","key":"2019100317053967500_B8","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.7863\/jum.2006.25.8.1031","article-title":"Quantitative Ultrasound Assessment of the Rat Cervix","volume":"25","year":"2006","journal-title":"J. Ultrasound Med."},{"issue":"3","key":"2019100317053967500_B9","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/016173461003200302","article-title":"Quantitative Ultrasound Assessment of Cervical Microstructure","volume":"32","year":"2010","journal-title":"Ultrason. Imaging"},{"issue":"2","key":"2019100317053967500_B10","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1002\/uog.7643","article-title":"Ultrasonic Attenuation Estimation of the Pregnant Cervix: A Preliminary Report","volume":"36","year":"2010","journal-title":"Ultrasound Obstet. Gynecol."},{"issue":"1","key":"2019100317053967500_B11","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ultras.2010.05.005","article-title":"Estimate of the Attenuation Coefficient using a Clinical Array Transducer for the Detection of Cervical Ripening in Human Pregnancy","volume":"51","year":"2011","journal-title":"Ultrasonics"},{"key":"2019100317053967500_B12","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ajog.2012.05.015","article-title":"Beyond Cervical Length: Emerging Technologies for Assessing the Pregnant Cervix","volume":"207","year":"2012","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"6","key":"2019100317053967500_B13","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1002\/uog.3850","article-title":"The Cervix as a Biomechanical Structure","volume":"28","year":"2006","journal-title":"Ultrasound Obstet. Gynecol."},{"issue":"5","key":"2019100317053967500_B14","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/0002-9378(74)90608-5","article-title":"The Effect of Pregnancy and Labor on the Human Cervix: Changes in Collagen, Glycoproteins, and Glycosaminoglycans","volume":"120","year":"1974","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"3","key":"2019100317053967500_B15","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1620\/tjem.131.289","article-title":"Glycoconjugates (Glycosaminoglycans and Glycoproteins) and Glycogen in the Human Cervix Uteri","volume":"131","year":"1980","journal-title":"Tohoku J. Exp. Med."},{"issue":"4","key":"2019100317053967500_B16","first-page":"563","article-title":"Connective Tissue Changes in the Cervix during Normal Pregnancy and Pregnancy Complicated by Cervical Incompetence","volume":"71","year":"1988","journal-title":"Obstet. Gynecol."},{"issue":"Suppl 1","key":"2019100317053967500_B17","first-page":"S82","article-title":"Changes in the Biochemical Constituents and Morphologic Appearance of the Human Cervical Stroma during Pregnancy","volume":"144","year":"2009","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"2019100317053967500_B18","first-page":"59","article-title":"Elastin and Collagen in the Human Uterus and Cervix","volume-title":"The Extracellular Matrix of the Uterus, Cervix and Fetal Membranes: Synthesis, Degradation and Hormonal Regulation","year":"1991"},{"issue":"5","key":"2019100317053967500_B19","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1016\/j.ajog.2004.03.080","article-title":"Physical and Biomechanical Characteristics of Rat Cervical Ripening are not Consistent with Increased Collagenase Activity","volume":"191","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"5","key":"2019100317053967500_B20","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1053\/j.semperi.2009.06.002","article-title":"Relationships Between Mechanical Properties and Extracellular Matrix Constituents of the Cervical Stroma During Pregnancy","volume":"33","year":"2009","journal-title":"Semin. Perinatol."},{"issue":"5","key":"2019100317053967500_B21","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1095\/biolreprod.110.089599","article-title":"Cervical Softening during Pregnancy-Regulated Changes in Collagen Cross-Linking and Composition of Matricellular Proteins in the Mouse","volume":"84","year":"2011","journal-title":"Biol Reprod."},{"issue":"4","key":"2019100317053967500_B22","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/0002-9378(47)90273-1","article-title":"The Fibrous Nature of the Human Cervix, and its Relation to the Isthmic Segment in Gravid and Nongravid Uteri","volume":"53","year":"1947","journal-title":"Am. J. Obstet. Gynecol."},{"key":"2019100317053967500_B23","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/0002-9378(60)90472-5","article-title":"Connective Tissue Changes Incident to Cervical Effacement","volume":"80","year":"1960","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"1","key":"2019100317053967500_B24","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/00003081-198303000-00005","article-title":"The Morphology of the Human Cervix","volume":"26","year":"1983","journal-title":"Clin. Obstet. Gynecol."},{"key":"2019100317053967500_B25","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3109\/14767059209161921","article-title":"Cervical Softening, Effacement, and Dilatation: A Complex Biochemical Cascade","volume":"1","year":"1992","journal-title":"J. Matern. Fetal Med."},{"issue":"2","key":"2019100317053967500_B26","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/00003081-199506000-00009","article-title":"Anatomy and Physiology of Cervical Ripening","volume":"38","year":"1995","journal-title":"Clin. Obstet. Gynecol."},{"key":"2019100317053967500_B27","first-page":"103","article-title":"The Biochemistry and Physiology of the Uterine Cervix during Gestation and Parturition","volume":"3","year":"1998","journal-title":"Prenat. Neonat. Med."},{"key":"2019100317053967500_B28","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1055\/s-2006-956777","article-title":"Dynamics of Cervical Remodeling during Pregnancy and Parturition: Mechanisms and Current Concepts","volume":"25","year":"2007","journal-title":"Semin. Reprod. Med."},{"issue":"6","key":"2019100317053967500_B29","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.tem.2010.01.011","article-title":"Cervical Remodeling during Pregnancy and Parturition","volume":"21","year":"2010","journal-title":"Trends Endocrinol. Metab."},{"issue":"3","key":"2019100317053967500_B30","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1210\/en.2010-1105","article-title":"The Molecular Mechanisms of Cervical Ripening Differ Between Term and Preterm Birth","volume":"152","year":"2011","journal-title":"Endocrinology"},{"issue":"4","key":"2019100317053967500_B31","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1530\/REP-11-0466","article-title":"Cervical Remodeling in Term and Preterm Birth: Insights from an Animal Model","volume":"143","year":"2012","journal-title":"Reprod."},{"key":"2019100317053967500_B32","doi-asserted-by":"crossref","first-page":"3493","DOI":"10.1210\/en.2011-1950","article-title":"Dynamic Changes in Cervical Glycosaminoglycan Composition during Normal Pregnancy and Preterm Birth","volume":"153","year":"2012","journal-title":"Endocrinology"},{"issue":"8","key":"2019100317053967500_B33","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1002\/nbm.1507","article-title":"Ex Vivo Assessment of Mouse Cervical Remodeling Through Pregnancy via 23Na MRS","volume":"23","year":"2010","journal-title":"NMR Biomed."},{"issue":"4","key":"2019100317053967500_B34","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/S0021-9290(02)00437-2","article-title":"New Insight into Deformation-Dependent Hydraulic Permeability of Gels and Cartilage, and Dynamic Behavior of Agarose Gels in Confined Compression","volume":"36","year":"2003","journal-title":"J. Biomech."},{"issue":"10","key":"2019100317053967500_B35","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/S0021-9290(98)00105-5","article-title":"Experimental Verification and Theoretical Prediction of Cartilage Interstitial Fluid Pressurization at an Impermeable Contact Interface in Confined Compression","volume":"31","year":"1998","journal-title":"J. Biomech."},{"issue":"23","key":"2019100317053967500_B36","doi-asserted-by":"crossref","first-page":"2449","DOI":"10.1097\/00007632-199912010-00005","article-title":"The Anisotropic Hydraulic Permeability of Human Lumbar Anulus Fibrosus: Influence of Age, Degeneration, Direction, and Water Content","volume":"24","year":"1999","journal-title":"Spine"},{"issue":"1","key":"2019100317053967500_B37","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.actbio.2007.04.009","article-title":"Mechanical and Biochemical Properties of Human Cervical Tissue","volume":"4","year":"2008","journal-title":"Acta Biomater."},{"issue":"2","key":"2019100317053967500_B38","doi-asserted-by":"crossref","first-page":"021003","DOI":"10.1115\/1.3197847","article-title":"A Study of the Anisotropy and Tension\/Compression Behavior of Human Cervical Tissue","volume":"132","year":"2010","journal-title":"J. Biomech. Eng."},{"issue":"1","key":"2019100317053967500_B39","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1115\/1.3138202","article-title":"Biphasic Creep and Stress Relaxation of Articular Cartilage in Compression: Theory and Experiments","volume":"102","year":"1980","journal-title":"J. Biomech. Eng."},{"key":"2019100317053967500_B40","volume-title":"Biomechanics: Mechanical Properties of Living Tissues","year":"1993"},{"key":"2019100317053967500_B41","volume-title":"Analysis of Transport Phenomena","year":"1998"},{"key":"2019100317053967500_B42","doi-asserted-by":"crossref","unstructured":"Myers, K. M., Oyen, M., Yoshida, K., Fernandez, M., Vink, J., and Wapner, R., 2012, \u201cTime-Dependent Indentation Response of Human Cervical Tissue,\u201d Proceedings of the ASME Summer Bioengineering Conference, Farjardo, Puerto Rico.","DOI":"10.1115\/SBC2012-80863"},{"key":"2019100317053967500_B43","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1557\/jmr.2009.0129","article-title":"Viscoelastic and Poroelastic Mechanical Characterization of Hydrated Gels","volume":"24","year":"2009","journal-title":"J. Mater. Res."},{"issue":"2","key":"2019100317053967500_B44","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1006\/jcis.2001.7633","article-title":"Rheology and Permeability of Crosslinked Polyacrylamide Gel","volume":"240","year":"2001","journal-title":"J. Colloid Interface Sci."},{"key":"2019100317053967500_B45","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/biomet\/73.1.13","article-title":"Longitudinal Data Analysis using Generalized Linear Models","volume":"73","year":"1986","journal-title":"Biometrika"},{"issue":"47","key":"2019100317053967500_B46","first-page":"825","article-title":"Estimating Equations for Parameters in Means and Covariances of Multivariate Discrete and Continuous Responses","volume":"28","year":"1991","journal-title":"Biometrics"},{"key":"2019100317053967500_B47","doi-asserted-by":"crossref","first-page":"026020","DOI":"10.1117\/1.3381184","article-title":"Second Harmonic Generation Imaging as a Potential Tool for Staging Pregnancy and Predicting Preterm Birth","volume":"15","year":"2010","journal-title":"J. Biomed. Opt."},{"key":"2019100317053967500_B48","first-page":"5314","article-title":"Separation of Preterm Infection Model from Normal Pregnancy in Mice using Texture Analysis of Second Harmonic Generation Images","volume":"2010","year":"2010","journal-title":"Conf. Proc. IEEE Eng. Med. Biol. Soc."},{"issue":"11","key":"2019100317053967500_B49","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1016\/0021-9290(90)90007-P","article-title":"The Nonlinear Characteristics of Soft Gels and Hydrated Connective Tissues in Ultrafiltration","volume":"23","year":"1990","journal-title":"J. Biomech."},{"issue":"2","key":"2019100317053967500_B50","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1114\/1.239","article-title":"Interstitial Fluid Pressurization During Confined Compression Cyclical Loading of Articular Cartilage","volume":"28","year":"2000","journal-title":"Ann. Biomed. Eng."},{"key":"2019100317053967500_B51","first-page":"84","article-title":"Three-Dimensional Fiber Architecture of the Nonpregnant Human Uterus Determined Ex Vivo Using Magnetic Resonance Diffusion Tensor Imaging","volume":"288","year":"2006","journal-title":"Anat. Rec. A Discov. Mol. Cell Evol. Biol."},{"key":"2019100317053967500_B52","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0174-173X(88)80022-0","article-title":"Collagen Organization in the Cervix and Its Relation to Mechanical Function","volume":"8","year":"1988","journal-title":"Coll. Relat. Res."}],"container-title":["Journal of Biomechanical Engineering"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/doi\/10.1115\/1.4023380\/6089455\/bio_135_2_021024.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/doi\/10.1115\/1.4023380\/6089455\/bio_135_2_021024.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T21:06:04Z","timestamp":1570136764000},"score":1,"resource":{"primary":{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article\/doi\/10.1115\/1.4023380\/371420\/Direct-Measurement-of-the-Permeability-of-Human"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,1]]},"references-count":52,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,2,1]]}},"URL":"https:\/\/doi.org\/10.1115\/1.4023380","relation":{},"ISSN":["0148-0731","1528-8951"],"issn-type":[{"value":"0148-0731","type":"print"},{"value":"1528-8951","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2,1]]},"article-number":"021024"}}