SignificancePreterm birth is defined as a birth before 37 weeks of gestation and is one of the leading contributors to infant mortality rates globally. Premature birth can lead to life-long developmental impairment for the child. Unfortunately, there is a significant lack of tools to diagnose preterm birth risk, which limits patient care and the development of new therapies.AimTo develop a speculum-free, portable preterm imaging system (PPRIM) for cervical imaging; testing of the PPRIM system to resolve polarization properties of birefringent samples; and testing of the PPRIM under an IRB on healthy, non-pregnant volunteers for visualization and polarization analysis of cervical images.ApproachThe PPRIM can perform 4×3 Mueller-matrix imaging to characterize the remodeling of the uterine cervix during pregnancy. The PPRIM is built with a polarized imaging probe and a flexible insertable sheath made with a compatible flexible rubber-like material to maximize comfort and ease of use.ResultsThe PPRIM device is developed to meet specific design specifications as a speculum-free, portable, and comfortable imaging system with polarized imaging capabilities. This system comprises a main imaging component and a flexible silicone inserter. The inserter is designed to maximize comfort and usability for the patient. The PPRIM shows high-resolution imaging capabilities at the 20 mm working distance and 25 mm circular field of view. The PPRIM demonstrates the ability to resolve birefringent sample orientation and full field capture of a healthy, non-pregnant cervix.ConclusionThe development of the PPRIM aims to improve access to the standard of care for women’s reproductive health using polarized Mueller-matrix imaging of the cervix and reduce infant and maternal mortality rates and better quality of life.
Preterm birth (PTB) is defined as any birth prior to 37 weeks of gestation. Preterm birth contributes to 35% of 3.1 million neonatal deaths annually. There is a critical absence of clinical tools for diagnosis of preterm birth risk. We have proposed the use of Mueller Matrix Imaging (MMI) as a sensitive tool to monitor the atypical remodeling of collagen occurring in PTB. Here we expand our previous work to demonstrate that a Portable PReterm IMaging System capable of 3x4 MMI can be used at the point of care. It consists of a sheath insertable in the vaginal canal combined with a polarized imaging system. The main PPRIM body consists of a camera with integrated polarizers combined with a custom-made LED ring illuminator. The optical layout consists of a reverse telephoto lens suitable for imaging at long front working distance. Angle of incidence of the optical elements are minimized to reduce the sensitivity to misalignment and polarization aberrations. The system has a field of view of approximately 25 x 25 mm2 at 20 mm working distance. PPRIM is controlled by a laptop computer and custom software. To demonstrate the feasibility of the device, imaging tests were performed on a Gynecologic Skills Trainer as well as healthy volunteers.
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