Using Raman Spectroscopy for Assessing Cervical Change During Labor: An Objective Approach to Labor Management [31T

Abstract

INTRODUCTION: Subjective assessment of digital examination can lead to different interpretations of cervical change and may affect labor management decisions. The aim of this study is to assess using Raman Spectroscopy to identify biochemical signatures associated with cervical change during labor. METHODS: At a major medical center, 10 adult pregnant patients were recruited and enrolled. The exclusion criteria were non-English speakers, prior preterm birth, prior LEEP, preterm labor or PROM. A portable Raman system with imaging-spectrograph, 785 nm diode laser, and fiber-optic probe were used. Measurements were taken at each prenatal visit starting at 37 weeks and during labor. The probe was placed at 3-6-9, and 12 o'clock positions and spectra were obtained. Both prenatal and labor peak ratios were compared and analyzed as function of cervical dilation. RESULTS: The average age and BMI were 25 years and 35.4 kg/m2 respectively. 40% underwent induction of labor with an average cervical dilation of 2.7 cm on admission. Raman peak amplitudes associated with extracellular matrix (ECM) proteins displayed significant differences between spectra measured at prenatal visits vs. labor. These included amide III band at 1253 cm-1 (P=.004), collagen and lipid-associated band at 1454 cm-1 (p=.001), and amide I band 1654 cm-1 (P=1.05x10-5). The 1454 cm-1band showed a distinct increase as a function of cervical dilation. CONCLUSION: Our study demonstrates that Raman spectroscopy is sensitive to biochemical changes in the cervix prior to the onset of labor as well as during labor progress. This may suggest reorganization of the ECM as the cervix remodels during labor.