Point-of-care monitoring of feto-placental oxygen uptake Summary / Abstract The âGreat Obstetrical syndromesâ are the leading cause of maternal and fetal mortality world-wide. Despite the fact, that the origin of these syndromes is associated with pathology of deep placentation and abnormal vascular remodeling, there are no tools, allowing early point-of-care diagnosis, prior to maternal pregnancy complication become evident and pathophysiological cascade of events develops. Pathology of deep placentation leads to abnormal blood flow in materno-fetal unit and to inefficient oxygen exchange between maternal and fetal circulations, which could be measured as uterine arterio-venous oxygen ratio (AVOR). The optoacoustic imaging technology would potentially allow measuring AVOR with unprecedented accuracy during the window of opportunity for early intervention. While the first clinical application of optoacoustic tomography enabled functional imaging, many burdens remain to be removed. The accuracy of quantitative information, contrast and resolution and image artifacts and video rate of blood content and its oxygen saturation are still not sufficient for usage at the patient's bedside. However recent breakthroughs in the system components give solid basis for development of a compact, robust and inexpensive functional imaging technology. Thus, based on pathophysiological relevance of uterine arterio-venous oxygen ratio (AVOR) in pregnancy complication and the progress in the optoacoustic biophysical methods, we propose to develop the first clinical prototype system of a novel hybrid laser optoacoustic-ultrasonic medical device (MD) for noninvasive evaluation of spatially resolved maps of blood flow and its oxygen content in uterine venous and arterial vascular trees (AVOR-MD). Thus Aim 1 of the proposed study is to develop a compact, robust and accurate functional system for monitoring differences in veno-arterial blood oxygenation; Aim 2 is to perform feasibility testing of the developed system and method initially in phantoms and then in ex-vivo studies of blood perfused placenta. In the Phase I of the SBIR project we will develop the system specifications, fabricate the dual modality optoacoustic-ultrasonic probe, improve speed and quantitative accuracy of functional imaging and demonstrate feasibility of our approach in ex vivo blood-perfused organs, including human placenta. The team of investigators has a unique, 60 years combined experience in obstetrics and gynecology, placental biology and biophysics. The successful completion of this proposal will allow simple, rapid diagnosis of life threatening pregnancy complications prior to the development of clinical syndromes, moreover â the proposed equipment could be used in neonatal care. 1
Public Health Relevance Statement: Project title: Point-of-care monitoring of feto-placental oxygen uptake NARRATIVE Great obstetrical syndromes- leading cause of maternal and newborn mortality, are associated with abnormal blood flow in materno-fetal unit and inefficient oxygen exchange between maternal and fetal circulation, measured as uterine arterio-venous ratio. The optoacoustic imaging technology represents a unique opportunity to measure this important parameter with unprecedented accuracy during the window of opportunity for early intervention. The goal of the proposed project is to develop the first clinical prototype system of a novel imaging system for point of care monitoring pathology of deep placentation.
Project Terms: Abdomen; Accounting; Acoustics; Arteries; Back; base; biophysical techniques; Biophysics; Blood; Blood Circulation; Blood flow; blood flow measurement; Blood Vessels; Clinical; clinical application; clinical development; Code; Complex; Computer Simulation; Computer software; Crystallization; design; Development; Devices; Diagnosis; Diagnostic Imaging; digital; Discipline of obstetrics; Early Intervention; Electronics; Equipment; Evaluation; Event; experience; experimental study; feeding; fetal; Fetal Mortality Statistics; Functional Imaging; Generations; Geometry; Goals; Gynecology; Hand; Human; Hybrids; Image; Imagery; imaging system; Imaging technology; improved; Individual; Lasers; Legal patent; Life; Light; Lighting; malignant breast neoplasm; Maps; Maternal Complication of Pregnancy; Maternal Mortality; Measurement; Measures; Medical Device; Methodology; Methods; Modality; Modern Literature; Monitor; Monte Carlo Method; Morphologic artifacts; neonatal care; Neonatal Mortality; novel; Optics; optoacoustic tomography; Organ; Oxygen; Pathology; Patients; Phase; photoacoustic imaging; photonics; Physiologic pulse; Placenta; Placental Biology; Placentation; point of care; Point-of-Care Systems; Pre-Eclampsia; Pregnancy Complications; Premature Labor; Property; prototype; Publishing; Pump; rapid diagnosis; reconstruction; Research Personnel; Resolution; response; Side; Signal Transduction; Small Business Innovation Research Grant; Solid; solid state; Source; Speed; Stillbirth; Syndrome; System; Technology; Testing; tissue phantom; Tissues; tool; Transducers; Trees; Ultrasonic Transducer; Ultrasonics; Ultrasonography; uptake; Validation; vascular abnormality; Vascular remodeling; Veins; V
