On the deformation behavior of human amnion

Pregnancy state before the onset of labor: a holistic mechanical perspective

Successful pregnancy highly depends on the complex interaction between the uterine body, cervix, and fetal membrane. This interaction is synchronized, usually following a specific sequence in normal vaginal deliveries: (1) cervical ripening, (2) uterine contractions, and (3) rupture of fetal membrane. The complex interaction between the cervix, fetal membrane, and uterine contractions before the onset of labor is investigated using a complete third-trimester gravid model of the uterus, cervix, fetal membrane, and abdomen. Through a series of numerical simulations, we investigate the mechanical impact of (i) initial cervical shape, (ii) cervical stiffness, (iii) cervical contractions, and (iv) intrauterine pressure. The findings of this work reveal several key observations: (i) maximum principal stress values in the cervix decrease in more dilated, shorter, and softer cervices; (ii) reduced cervical stiffness produces increased cervical dilation, larger cervical opening, and decreased cervical length; (iii) the initial cervical shape impacts final cervical dimensions; (iv) cervical contractions increase the maximum principal stress values and change the stress distributions; (v) cervical contractions potentiate cervical shortening and dilation; (vi) larger intrauterine pressure (IUP) causes considerably larger stress values and cervical opening, larger dilation, and smaller cervical length; and (vii) the biaxial strength of the fetal membrane is only surpassed in the cases of the (1) shortest and most dilated initial cervical geometry and (2) larger IUP.

Development of a multilayer fetal membrane material model calibrated using bulge inflation mechanical tests

The fetal membranes are an essential mechanical structure for pregnancy, protecting the developing fetus in an amniotic fluid environment and rupturing before birth. In cooperation with the cervix and the uterus, the fetal membranes support the mechanical loads of pregnancy. Structurally, the fetal membranes comprise two main layers: the amnion and the chorion. The mechanical characterization of each layer is crucial to understanding how each layer contributes to the structural performance of the whole membrane. The in-vivo mechanical loading of the fetal membranes and the amount of tissue stress generated in each layer throughout gestation remains poorly understood, as it is difficult to perform direct measurements on pregnant patients. Finite element analysis of pregnancy offers a computational method to explore how anatomical and tissue remodeling factors influence the load-sharing of the uterus, cervix, and fetal membranes. To aid in the formulation of such computational models of pregnancy, this work develops a fiber-based multilayer fetal membrane model that captures its response to previously published bulge inflation loading data. First, material models for the amnion, chorion, and maternal decidua are formulated, informed, and validated by published data. Then, the behavior of the fetal membrane as a layered structure was analyzed, focusing on the respective stress distribution and thickness variation in each layer. The layered computational model captures the overall behavior of the fetal membranes, with the amnion being the mechanically dominant layer. The inclusion of fibers in the amnion material model is an important factor in obtaining reliable fetal membrane behavior according to the experimental dataset. These results highlight the potential of this layered model to be integrated into larger biomechanical models of the gravid uterus and cervix to study the mechanical mechanisms of preterm birth.

Cracks in tensile-contracting and tensile-dilating poroelastic materials

Fibrous gels such as cartilage, blood clots, and carbon-nanotube-based sponges with absorbed oils suffer a reduction in volume by the expulsion of liquid under uniaxial tension, and this directly affects crack-tip fields and energy release rates. A continuum model is formulated for isotropic fibrous gels that exhibit a range of behaviors from volume increasing to volume decreasing in uniaxial tension by changing the ratio of two material parameters. The motion of liquid in the pores of such gels is modeled using poroelasticity. The direction of liquid fluxes around cracks is shown to depend on whether the gel locally increases or decreases in volume. The energy release rate for cracks is computed using a surface-independent integral and it is shown to have two contributions - one from the stresses in the solid network, and another from the flow of liquid. The contribution to the integral from liquid permeation tends to be negative when the gel exhibits volume decrease, which effectively is a crack shielding mechanism.

Stiffening mechanisms in stochastic athermal fiber networks

Stochastic athermal networks composed of fibers that deform axially and in bending strain stiffen much faster than thermal networks of axial elements, such as elastomers. Here we investigate the physical origin of stiffening in athermal network materials. To this end, we use models of stochastic networks subjected to uniaxial deformation and identify the emergence of two subnetworks, the stress path subnetwork (SPSN) and the bending support subnetwork (BSSN), which carry most of the axial and bending energies, respectively. The BSSN controls lateral contraction and modulates the organization of the SPSN during deformation. The SPSN is preferentially oriented in the loading direction, while the BSSN's preferential orientation is orthogonal to the SPSN. In nonaffine networks stiffening is exponential, while in close-to-affine networks it is quadratic. The difference is due to a much more modest lateral contraction in the approximately affine case and to a stiffer BSSN. Exponential stiffening emerges from the interplay of the axial and bending deformation modes at the scale of individual or small groups of fibers undergoing large deformations and being subjected to the constraint of rigid cross-links, and it is not necessarily a result of complex interactions involving many connected fibers. An apparent third regime of quadratic stiffening may be evidenced in nonaffinely deforming networks provided the nominal stress is observed. This occurs at large stretches, when the BSSN contribution of stiffening vanishes. However, this regime is not present if the Cauchy stress is used, in which case stiffening is exponential throughout the entire deformation. These results shed light on the physical nature of stiffening in a broad class of materials including connective tissue, the extracellular matrix, nonwovens, felt, and other athermal network materials.

Cx43 regulates mechanotransduction mechanisms in human preterm amniotic membrane defects

OBJECTIVE

The effects of mechanical stimulation in preterm amniotic membrane (AM) defects were explored.

METHODS

Preterm AM was collected from women undergoing planned preterm caesarean section (CS) due to fetal growth restriction or emergency CS after spontaneous preterm prelabour rupture of the membranes (sPPROM). AM explants near the cervix or placenta were subjected to trauma and/or mechanical stimulation with the Cx43 antisense. Markers for nuclear morphology (DAPI), myofibroblasts (αSMA), migration (Cx43), inflammation (PGE2 ) and repair (collagen, elastin and transforming growth factor β [TGFβ1 ]) were examined by confocal microscopy, second harmonic generation, qPCR and biochemical assays.

RESULTS

In preterm AM defects, myofibroblast nuclei were highly deformed and contractile and expressed αSMA and Cx43. Mechanical stimulation increased collagen fibre polarisation and the effects on matrix markers were dependent on tissue region, disease state, gestational age and the number of fetuses. PGE2 levels were broadly similar but reduced after co-treatment with Cx43 antisense in late sPPROM AM defects. TGFβ1 and Cx43 gene expression were significantly increased after trauma and mechanical stimulation but this response dependent on gestational age.

CONCLUSION

Mechanical stimulation affects Cx43 signalling and cell/collagen mechanics in preterm AM defects. Establishing how Cx43 regulates mechanosignalling could be an approach to repair tissue integrity after trauma.

Fracture toughness of fibrin gels as a function of protein volume fraction: Mechanical origins

The mechanical stability of blood clots necessary for their functions is provided by fibrin, a fibrous gel. Rupture of clots leads to life-threatening thrombotic embolization, which is little understood. Here, we combine experiments and simulations to determine the toughness of plasma clots as a function of fibrin content and correlate toughness with fibrin network structure characterized by confocal and scanning electron microscopy. We develop fibrin constitutive laws that scale with fibrin concentration and capture the force-stretch response of cracked clot specimens using only a few material parameters. Toughness is calculated from the path-independent J* integral that includes dissipative effects due to fluid flow and uses only the constitutive model and overall stretch at crack propagation as input. We show that internal fluid motion, which is not directly measurable, contributes significantly to clot toughness, with its effect increasing as fibrin content increases, because the reduced gel porosity at higher density results in greater expense of energy in fluid motion. Increasing fibrin content (1→10mg/mL) results in a significant increase in clot toughness (3→15 N/m) in accordance with a power law relation reminiscent of cellular solids and elastomeric gels. These results provide a basis for understanding and predicting the tendency for thrombotic embolization. STATEMENT OF SIGNIFICANCE: Fibrin, a naturally occurring biomaterial, is the major determinant of the structural and mechanical integrity of blood clots. We determined that increasing the fibrin content in clots, as in some thrombi and fibrin-based anti-bleeding sealants, results in an increase in clot toughness. Toughness corresponds to the ability to resist rupturing in the presence of a defect. We couple bulk mechanical testing, microstructural measurements, and finite element modeling to capture the force-stretch response of fibrin clots and compute toughness. We show that increased fibrin content in clots reduces porosity and limits fluid motion and that fluid motion drastically alters the clot toughness. These results provide a fundamental understanding of blood clot rupture and could help in rational design of fibrin-containing biomaterials.

Risky interpretations across the length scales: continuum vs. discrete models for soft tissue mechanobiology

Modelling and simulation in mechanobiology play an increasingly important role to unravel the complex mechanisms that allow resident cells to sense and respond to mechanical cues. Many of the in vivo mechanical loads occur on the tissue length scale, thus raising the essential question how the resulting macroscopic strains and stresses are transferred across the scales down to the cellular and subcellular levels. Since cells anchor to the collagen fibres within the extracellular matrix, the reliable representation of fibre deformation is a prerequisite for models that aim at linking tissue biomechanics and cell mechanobiology. In this paper, we consider the two-scale mechanical response of an affine structural model as an example of a continuum mechanical approach and compare it with the results of a discrete fibre network model. In particular, we shed light on the crucially different mechanical properties of the 'fibres' in these two approaches. While assessing the capability of the affine structural approach to capture the fibre kinematics in real tissues is beyond the scope of our study, our results clearly show that neither the macroscopic tissue response nor the microscopic fibre orientation statistics can clarify the question of affinity.

Enthalpy of collagen interfibrillar bonds in fetal membranes

During pregnancy, the fetal membrane (FM) is subjected to mechanical stretching that may result in preterm labor. The structural integrity of the FM is maintained by its collagenous layer. The disconnection and reconnection of molecular bonds between collagen fibrils are the fundamental processes that govern the irreversible mechanical and supermolecular changes in the FM. Here, we study the activation enthalpy of interfibrillar bonds in ex-vivo human FM. We analyze the strain-rate and temperature dependence of the irreversible deformations in FM subjected to inflation tests, which apply mechanical conditions similar to those experienced by the FM prior to and during the initiation of labor contractions. The obtained activation enthalpy of interfibrillar bonds matches the typical enthalpy values of polyvalent ionic bonds, implying on another important role that ions like Ca and Mg may play in the gestation and labor.

Visco- and poroelastic contributions of the zona pellucida to the mechanical response of oocytes

Probing mechanical properties of cells has been identified as a means to infer information on their current state, e.g. with respect to diseases or differentiation. Oocytes have gained particular interest, since mechanical parameters are considered potential indicators of the success of in vitro fertilisation procedures. Established tests provide the structural response of the oocyte resulting from the material properties of the cell's components and their disposition. Based on dedicated experiments and numerical simulations, we here provide novel insights on the origin of this response. In particular, polarised light microscopy is used to characterise the anisotropy of the zona pellucida, the outermost layer of the oocyte composed of glycoproteins. This information is combined with data on volumetric changes and the force measured in relaxation/cyclic, compression/indentation experiments to calibrate a multi-phasic hyper-viscoelastic model through inverse finite element analysis. These simulations capture the oocyte's overall force response, the distinct volume changes observed in the zona pellucida, and the structural alterations interpreted as a realignment of the glycoproteins with applied load. The analysis reveals the presence of two distinct timescales, roughly separated by three orders of magnitude, and associated with a rapid outflow of fluid across the external boundaries and a long-term, progressive relaxation of the glycoproteins, respectively. The new results allow breaking the overall response down into the contributions from fluid transport and the mechanical properties of the zona pellucida and ooplasm. In addition to the gain in fundamental knowledge, the outcome of this study may therefore serve an improved interpretation of the data obtained with current methods for mechanical oocyte characterisation.

Direct measurement of the direction-dependent mechanical behaviour of skeletal muscle extracellular matrix

This paper reports the first comprehensive data set on the anisotropic mechanical properties of isolated endo- and perimysial extracellular matrix of skeletal muscle, and presents the corresponding protocols for preparing and testing the samples. In particular, decellularisation of porcine skeletal muscle is achieved with caustic soda solution, and mechanical parameters are defined based on compressive and tensile testing in order to identify the optimal treatment time such that muscle fibres are dissolved whereas the extracellular matrix remains largely intact and mechanically functional. At around 18 h, a time window was found and confirmed by histology, in which axial tensile experiments were performed to characterise the direction-dependent mechanical response of the extracellular matrix samples, and the effect of lateral pre-compression was studied. The typical, large variability in the experimental stress response could be largely reduced by varying a single scalar factor, which was attributed to the variation of the fraction of extracellular matrix within the tissue. While experimental results on the mechanical properties of intact muscle tissue and single muscle fibres are increasingly available in literature, there is a lack of information on the properties of the collagenous components of skeletal muscle. The present work aims at closing this gap and thus contributes to an improved understanding of the mechanics of skeletal muscle tissue and provides a missing piece of information for the development of corresponding constitutive and computational models.

Predicting muscle tissue response from calibrated component models and histology-based finite element models

Skeletal muscle is an anisotropic soft biological tissue composed of muscle fibres embedded in a structurally complex, hierarchically organised extracellular matrix. In a recent work (Kuravi et al., 2021) we have developed 3D finite element models from series of histological sections. Moreover, based on decellularisation of fresh tissue samples, a novel set of experimental data on the direction dependent mechanical properties of collagenous ECM was established (Kohn et al., 2021). Together with existing information on the material properties of single muscle fibres, the combination of these techniques allows computing predictions of the composite tissue response. To this end, an inverse finite element procedure is proposed in the present work to calibrate a constitutive model of the extracellular matrix, and supplementary biaxial tensile tests on fresh and decellularised tissues are performed for model validation. The results of this rigorously predictive and thus unforgiving strategy suggest that the prediction of the tissue response from the individual characteristics of muscle cells and decellularised tissue is only possible within clear limits. While orders of magnitude are well matched, and the qualitative behaviour in a wide range of load cases is largely captured, the existing deviations point at potentially missing components of the model and highlight the incomplete experimental information in bottom-up multiscale approaches to model skeletal muscle tissue.

Dynamic measurement of amnion thickness during loading by speckle pattern interferometry

INTRODUCTION

In previous studies on the mechanical parameters of amnions (AM), there is a limitation due to the lack of an accurate thickness measurement, which is an important parameter for determining AM-specific mechanical properties. As a bottleneck, the characterization of the basic mechanical properties of AM are greatly restricted, even with the proposal of fracture criteria.

METHOD

First, the initial thickness of the AM is estimated by the interpolated-volume-area method. Second, through combinations of our self-developed mini-biaxial tensile device with speckle pattern interferometry, this is the first time that researchers can accurately obtain the AM thickness at each transient moment in the process of loading.

RESULTS

Based on the experimental results, an accurate stress-strain curve could be obtained. Two important mechanical parameters-the fracture energy density and amnion rupture modulus-could be extracted as 0.184±0.036MPa and 108.57±17.32MPa, respectively. The fracture energy density and amnion rupture modulus provide objective criteria and a scientific basis for the evaluation of AM rupture.

DISCUSSION

The tensile stress-strain curve of a normal human amnion shows a distinct J-shape. This proves that the experimental results are basically reliable. Both important parameters --the fracture energy density and amnion rupture modulus, can be calculated from the stress-strain curve. Extracting these two parameters is critical for the evaluation and prediction of ROM, PROM and PPROM.

Is there any objective and independent characterization and modeling of soft biological tissues?

The characterization of soft tissue raises several difficulties. Indeed, soft biological tissues usually shrink when dissected from their in vivo location. This shrinkage is characteristic of the release of residual stresses, since soft tissues are indeed often pre-stressed in their physiological configuration. During experimental loading, large extension at very low level of force are expected and assumed to be related to the progressive recruitment and stretching of fibers. However, the first phase of the mechanical test is also aiming at recovering the pre-stressed in vivo behavior. As a consequence, the initial phase, corresponding to the recovering of prestress and/or recruitment of fiberes, is questionable and frequently removed. One of the preferred methods to erase it consists in applying a preforce or prestress to the sample: this allows to easily get rid of the sample retensioning range. However this operation can impact the interpretation of the identified mechanical parameters. This study presents an evaluation of the impact of the data processing on the mechanical properties of a numerically defined material. For this purpose, a finite element simulation was performed to replicate a uniaxial tensile test on a biological soft tissue sample. The influence of different pre-stretches on the mechanical parameters of a second order Yeoh model was investigated. The Yeoh mechanical parameters, or any other strain energy density, depend strongly on any pre- and post-processing choices: they adapt to compensate the error made when choosing an arbitrary level of prestretch or prestress. This observation spreads to any modeling approach used in soft tissues. Mechanical parameters are indeed naturally bound to the choice of the pre-stretch (or pre-stress) through the elongation and the constitutive law. Regardless of the model, it would therefore be pointless to compare mechanical parameters if the conditions for the processing of experimental raw data are not fully documented.

Collagen bundling and alignment in equibiaxially stretched human amnion

We study irreversible collagen arrangement processes in ex-vivo human amnions subjected to inflation tests, which simulate the mechanical conditions prior to and during the initiation of labor uterine contractions. The investigation is focused on the center of the membrane where the stresses are maximal and equibiaxial. Second harmonic generation reveals an unexpected collagen rearrangement in the compact layer that is responsible for the structural integrity of the fetal membrane. The observed bundling and alignment of the collagen fibers indicate a deviation from the expected equibiaxial stress state. The statistical analysis of the fiber orientations provides information on two driving forces for collagen alignment: microscale flaws and macroscale deviation from the equibiaxial strain. As the pressure increases, the macroscale effect becomes dominant, and a high density of fibers that are aligned along a specific direction is observed. A model that explains these observations and relates them to the material properties is presented. The results of this study indicate that a temporal increase in intrauterine pressure or uterine cervix dilatation causes irreversible changes in collagen molecular connections that may lead to biological changes, such as the initiation of term and preterm labor.

Influence of osmolarity and hydration on the tear resistance of the human amniotic membrane

The amnion is considered to be the load-bearing part of the fetal membranes. We investigated the influence of osmolarity of the testing medium and hydration on its fracture toughness. Mode I fracture tests revealed that physiological variations in the bath osmolarity do not influence the tear resistance of amnion, while larger changes, i.e. from physiological saline solution to distilled water, lead to a significant reduction of the fracture toughness. Uniaxial tensile tests on collagen hydrogels confirmed the reduction in toughness, suggesting that lower bath osmolarity triggers changes in the failure properties of single collagen fibers. Prenatal surgeries, in particular fetoscopic procedures with partial amniotic carbon dioxide insufflation, might result in dehydration of the amnion. Dehydration induced a brittle behavior; however, subsequent rehydration for 15 min resulted in a similar tear resistance as for the fresh tissue.

On the defect tolerance of fetal membranes

A series of mechanical experiments were performed to quantify the strength and fracture toughness of human amnion and chorion. The experiments were complemented with computational investigations using a 'hybrid' model that includes an explicit representation of the collagen fibre network of amnion. Despite its much smaller thickness, amnion is shown to be stiffer, stronger and tougher than chorion, and thus to determine the mechanical response of fetal membranes, with respect to both, deformation and fracture behaviour. Data from uniaxial tension and fracture tests were used to inform and validate the computational model, which was then applied to rationalize measurements of the tear resistance of tissue samples containing crack-like defects. Experiments and computations show that the strength of amnion is not significantly reduced by defects smaller than 1 mm, but the crack size induced by perforations for amniocentesis and fetal membrane suturing during fetal surgery might be larger than this value. In line with previous experimental observations, the computational model predicts a very narrow near field at the crack tip of amnion, due to localized fibre alignment and collagen compaction. This mechanism shields the tissue from the defect and strongly reduces the interaction of multiple adjacent cracks. These findings were confirmed through corresponding experiments, showing that no interaction is expected for multiple sutures for an inter-suture distance larger than 1 mm and 3 mm for amnion and chorion, respectively. The experimental procedures and numerical models applied in the present study might be used to optimize needle and/or staple dimensions and inter-suture distance, and thus to reduce the risk of iatrogenic preterm premature rupture of the membranes from amniocentesis, fetoscopic and open prenatal surgery.

Cartography of the mechanical properties of the human amniotic membrane

Because of its low immunogenicity, biological properties, and high availability, the Human Amniotic Membrane (HAM) is widely used in the clinic and in tissue engineering research. However, while its biological characteristics are well described, its mechanical properties remain understudied especially in terms of inter- and intra-HAM variability. To guide bioengineers in the use of this natural biomaterial, a detailed cartography of the HAM's mechanical properties was performed. Maximal force (Fmax) and strain at break (Smax) were identified as the relevant mechanical criteria for this study after a combined analysis of histological sections, thickness measurements after dehydration, and uniaxial tensile tests. Eight HAMs were studied by mechanical cartography using a standardized cutting protocol and sampling pattern. On average, 103 ± 10 samples were retrieved and tested per HAM. Intra-tissue variability highlighted the fact that there were two mechanically distinct areas (placental and peripheral) in each HAM. For all HAMs, placental HAM was significantly stronger by 82 ± 45% and more stretchable by 19 ± 6% than their peripheral counterparts. Our results also demonstrated that placental, but not peripheral, HAM presented isotropic mechanical properties. Thus, placental HAM can be a raw material of choice that could be favored especially in the development of tissue engineering products where mechanical properties play a key role.

On the compressibility and poroelasticity of human and murine skin

A total of 37 human and 33 murine skin samples were subjected to uniaxial monotonic, cyclic, and relaxation experiments. Detailed analysis of the three-dimensional kinematic response showed that skin volume is significantly reduced as a consequence of a tensile elongation. This behavior is most pronounced in monotonic but persists in cyclic tests. The dehydration associated with volume loss depends on the osmolarity of the environment, so that tension relaxation changes as a consequence of modifying the ionic strength of the environmental bath. Similar to ex vivo observations, complementary in vivo stretching experiments on human volar forearms showed strong in-plane lateral contraction. A biphasic homogenized model is proposed which allows representing all relevant features of the observed mechanical response.

Tear resistance of soft collagenous tissues

Fracture toughness characterizes the ability of a material to maintain a certain level of strength despite the presence of a macroscopic crack. Understanding this tolerance for defects in soft collagenous tissues (SCT) has high relevance for assessing the risks of fracture after cutting, perforation or suturing. Here we investigate the peculiar toughening mechanisms of SCT through dedicated experiments and multi-scale simulations, showing that classical concepts of fracture mechanics are inadequate to quantify and explain the high defect tolerance of these materials. Our results demonstrate that SCT strength is only modestly reduced by defects as large as several millimeters. This defect tolerance is achieved despite a very narrow process zone at the crack tip and even for a network of brittle fibrils. The fracture mechanics concept of tearing energy fails in predicting failure at such defects, and its magnitude is shown to depend on the chemical potential of the liquid environment.

A Parameterized Ultrasound-Based Finite Element Analysis of the Mechanical Environment of Pregnancy

Preterm birth is the leading cause of childhood mortality and can lead to health risks in survivors. The mechanical functions of the uterus, fetal membranes, and cervix have dynamic roles to protect the fetus during gestation. To understand their mechanical function and relation to preterm birth, we built a three-dimensional parameterized finite element model of pregnancy. This model is generated by an automated procedure that is informed by maternal ultrasound measurements. A baseline model at 25 weeks of gestation was characterized, and to visualize the impact of cervical structural parameters on tissue stretch, we evaluated the model sensitivity to (1) anterior uterocervical angle, (2) cervical length, (3) posterior cervical offset, and (4) cervical stiffness. We found that cervical tissue stretching is minimal when the cervical canal is aligned with the longitudinal uterine axis, and a softer cervix is more sensitive to changes in the geometric variables tested.

Inverse poroelasticity as a fundamental mechanism in biomechanics and mechanobiology

Understanding the mechanisms of deformation of biological materials is important for improved diagnosis and therapy, fundamental investigations in mechanobiology, and applications in tissue engineering. Here we demonstrate the essential role of interstitial fluid mobility in determining the mechanical properties of soft tissues. Opposite to the behavior expected for a poroelastic material, the tissue volume of different collagenous membranes is observed to strongly decrease with tensile loading. Inverse poroelasticity governs monotonic and cyclic responses of soft biomembranes, and induces chemo-mechanical coupling, such that tensile forces are modulated by the chemical potential of the interstitial fluid. Correspondingly, the osmotic pressure varies with mechanical loads, thus providing an effective mechanism for mechanotransduction. Water mobility determines the tissue's ability to adapt to deformation through compaction and dilation of the collagen fiber network. In the near field of defects this mechanism activates the reversible formation of reinforcing collagen structures which effectively avoid propagation of cracks.How soft tissues respond to mechanical load is essential to their biological function. Here, the authors discover that - contrary to predictions of poroelasticity - fluid mobility in collagenous tissues induces drastic volume decrease with tensile loading and pronounced chemo-mechanical coupling.

Microstructure based prediction of the deformation behavior of soft collagenous membranes

The response of human amnion (HA) and bovine Glisson's capsule (GC) to uniaxial and biaxial tensile loading is analyzed on tissue (∼mm) and collagen fiber (∼μm) length scales. The mechanical behavior of the membranes is rationalized based on a discrete fiber network model that relates model parameters with microstructural features of the tissues. Parameters were first determined for GC based on the quantity and organization of collagen fibers in the tissue. Next, parameters for HA were defined by comparing the microstructures of the two membranes, which differ in fiber organization in that collagen forms μm-thick fiber bundles in GC while 50 nm-thin fibrils constitute the network in HA. The flexural behavior of these structures is phenomenologically represented in the model, indicating that shear forces are transmitted through fibrils within GC bundles, but to a much lesser extent than in a corresponding solid cross section. The model provides excellent predictions of the uniaxial and biaxial mechanical response, as well as of the progressive reorientation of fibers associated with uniaxial loading. The results are particularly relevant since model parameters were not obtained through a fitting procedure of the tissue's tension-stretch curve. Furthermore, simulations of representative in vivo deformation states indicated that a large part of the fibers are expected to be un-crimped under physiological loading conditions. Thus, the crimped shape of collagen fibers in the initial test configuration, and typically observed in histological analyses, might be a consequence of the contraction occurring when membranes are extracted from their environment in the body.

Mechanical Characteristics of Bovine Glisson's Capsule as a Model Tissue for Soft Collagenous Membranes

An extensive multiaxial experimental campaign on the monotonic, time- and history-dependent mechanical response of bovine Glisson's capsule (GC) is presented. Reproducible characteristics were observed such as J-shaped curves in uniaxial and biaxial configurations, large lateral contraction, cyclic tension softening, large tension relaxation, and moderate creep strain accumulation. The substantial influence of the reference state selection on the kinematic response and the tension versus stretch curves is demonstrated and discussed. The parameters of a large-strain viscoelastic constitutive model were determined based on the data of uniaxial tension relaxation experiments. The model is shown to well predict the uniaxial and biaxial viscoelastic responses in all other configurations. GC, the corresponding model, and the experimental protocols are proposed as a useful basis for future studies on the relation between microstructure and tissue functionality and on the factors influencing the mechanical response of soft collagenous membranes.

Characterization of irreversible physio-mechanical processes in stretched fetal membranes

We perform bulge tests on live fetal membrane (FM) tissues that simulate the mechanical conditions prior to contractions. Experimental results reveal an irreversible mechanical behavior that appears during loading and is significantly different than the mechanical behavior that appears during unloading or in subsequent loading cycles. The irreversible behavior results in a residual strain that does not recover upon unloading and remains the same for at least 1h after the FM is unloaded. Surprisingly, the irreversible behavior demonstrates a linear stress-strain relation. We introduce a new model for the mechanical response of collagen tissues, which accounts for the irreversible deformation and provides predictions in agreement with our experimental results. The basic assumption of the model is that the constitutive stress-strain relationship of individual elements that compose the collagen fibers has a plateau segment during which an irreversible transformation/deformation occurs. Fittings of calculated and measured stress-strain curves reveal a well-defined single-value property of collagenous tissues, which is related to the threshold strain εth for irreversible transformation. Further discussion of several physio-mechanical processes that can induce irreversible behavior indicate that the most probable process, which is in agreement with our results for εth, is a phase transformation of collagen molecules from an α-helix to a β-sheet structure. A phase transformation is a manifestation of a significant change in the molecular structure of the collagen tissues that can alter connections with surrounding molecules and may lead to critical biological changes, e.g., an initiation of labor.

STATEMENT OF SIGNIFICANCE

This study is driven by the hypothesis that pre-contraction mechanical stretch of the fetal membrane (FM) can lead to a change in the microstructure of the FM, which in turn induces a critical biological (hormonal) change that leads to the initiation of labor. We present mechanical characterizations of live FM tissues that reveal a significant irreversible process and a new model for the mechanical response of collagen tissues, which accounts for this process. Fittings of calculated and measured results reveal a well-defined single-value property of collagenous tissues, which is related to the threshold strain for irreversible transformation. Further discussion indicates that the irreversible deformation is induced by a phase transformation of collagen molecules that can lead to critical biological changes.

Computation of the effective mechanical response of biological networks accounting for large configuration changes

The asymptotic homogenization technique is involved to derive the effective elastic response of biological membranes viewed as repetitive beam networks. Thereby, a systematic methodology is established, allowing the prediction of the overall mechanical properties of biological membranes in the nonlinear regime, reflecting the influence of the geometrical and mechanical micro-parameters of the network structure on the overall response of the equivalent continuum. Biomembranes networks are classified based on nodal connectivity, so that we analyze in this work 3, 4 and 6-connectivity networks, which are representative of most biological networks. The individual filaments of the network are described as undulated beams prone to entropic elasticity, with tensile moduli determined from their persistence length. The effective micropolar continuum evaluated as a continuum substitute of the biological network has a kinematics reflecting the discrete network deformation modes, involving a nodal displacement and a microrotation. The statics involves the classical Cauchy stress and internal moments encapsulated into couple stresses, which develop internal work in duality to microcurvatures reflecting local network undulations. The relative ratio of the characteristic bending length of the effective micropolar continuum to the unit cell size determines the relevant choice of the equivalent medium. In most cases, the Cauchy continuum is sufficient to model biomembranes. The peptidoglycan network may exhibit a re-entrant hexagonal configuration due to thermal or pressure fluctuations, for which micropolar effects become important. The homogenized responses are in good agreement with FE simulations performed over the whole network. The predictive nature of the employed homogenization technique allows the identification of a strain energy density of a hyperelastic model, for the purpose of performing structural calculations of the shape evolutions of biomembranes.

Mechanical and microstructural investigation of the cyclic behavior of human amnion

The structural and mechanical integrity of amnion is essential to prevent preterm premature rupture (PPROM) of the fetal membrane. In this study, the mechanical response of human amnion to repeated loading and the microstructural mechanisms determining its behavior were investigated. Inflation and uniaxial cyclic tests were combined with corresponding in situ experiments in a multiphoton microscope (MPM). Fresh unfixed amnion was imaged during loading and changes in thickness and collagen orientation were quantified. Mechanical and in situ experiments revealed differences between the investigated configurations in the deformation and microstructural mechanisms. Repeated inflation induces a significant but reversible volume change and is characterized by high energy dissipation. Under uniaxial tension, volume reduction is associated with low energy, unrecoverable in-plane fiber reorientation.

Deformation mechanisms of human amnion: Quantitative studies based on second harmonic generation microscopy

Multiphoton microscopy has proven to be a versatile tool to analyze the three-dimensional microstructure of the fetal membrane and the mechanisms of deformation on the length scale of cells and the collagen network. In the present contribution, dedicated microscopic tools for in situ mechanical characterization of tissue under applied mechanical loads and the related methods for data interpretation are presented with emphasis on new stepwise monotonic uniaxial experiments. The resulting microscopic parameters are consistent with previous ones quantified for cyclic and relaxation tests, underlining the reliability of these techniques. The thickness reduction and the substantial alignment of collagen fiber bundles in the compact and fibroblast layer starting at very small loads are highlighted, which challenges the definition of a reference configuration in terms of a force threshold. The findings presented in this paper intend to inform the development of models towards a better understanding of fetal membrane deformation and failure, and thus of related problems in obstetrics and other clinical conditions.

Time-dependent mechanical behavior of human amnion: macroscopic and microscopic characterization

Characterizing the mechanical response of the human amnion is essential to understand and to eventually prevent premature rupture of fetal membranes. In this study, a large set of macroscopic and microscopic mechanical tests have been carried out on fresh unfixed amnion to gain insight into the time-dependent material response and the underlying mechanisms. Creep and relaxation responses of amnion were characterized in macroscopic uniaxial tension, biaxial tension and inflation configurations. For the first time, these experiments were complemented by microstructural information from nonlinear laser scanning microscopy performed during in situ uniaxial relaxation tests. The amnion showed large tension reduction during relaxation and small inelastic strain accumulation in creep. The short-term relaxation response was related to a concomitant in-plane and out-of-plane contraction, and was dependent on the testing configuration. The microscopic investigation revealed a large volume reduction at the beginning, but no change of volume was measured long-term during relaxation. Tension-strain curves normalized with respect to the maximum strain were highly repeatable in all configurations and allowed the quantification of corresponding characteristic parameters. The present data indicate that dissipative behavior of human amnion is related to two mechanisms: (i) volume reduction due to water outflow (up to ∼20 s) and (ii) long-term dissipative behavior without macroscopic deformation and no systematic global reorientation of collagen fibers.

Elastic-viscoplastic modeling of soft biological tissues using a mixed finite element formulation based on the relative deformation gradient

The characteristic highly nonlinear, time-dependent, and often inelastic material response of soft biological tissues can be expressed in a set of elastic-viscoplastic constitutive equations. The specific elastic-viscoplastic model for soft tissues proposed by Rubin and Bodner (2002) is generalized with respect to the constitutive equations for the scalar quantity of the rate of inelasticity and the hardening parameter in order to represent a general framework for elastic-viscoplastic models. A strongly objective integration scheme and a new mixed finite element formulation were developed based on the introduction of the relative deformation gradient-the deformation mapping between the last converged and current configurations. The numerical implementation of both the generalized framework and the specific Rubin and Bodner model is presented. As an example of a challenging application of the new model equations, the mechanical response of facial skin tissue is characterized through an experimental campaign based on the suction method. The measurement data are used for the identification of a suitable set of model parameters that well represents the experimentally observed tissue behavior. Two different measurement protocols were defined to address specific tissue properties with respect to the instantaneous tissue response, inelasticity, and tissue recovery.

About Puncture Testing Applied for Mechanical Characterization of Fetal Membranes

Puncture testing has been applied in several studies for the mechanical characterization of human fetal membrane (FM) tissue, and significant knowledge has been gained from these investigations. When comparing results of mechanical testing (puncture, inflation, and uniaxial tension), we have observed discrepancies in the rupture sequence of FM tissue and significant differences in the deformation behavior. This study was undertaken to clarify these discrepancies. Puncture experiments on FM samples were performed to reproduce previous findings, and numerical simulations were carried out to rationalize particular aspects of membrane failure. The results demonstrate that both rupture sequence and resistance to deformation depend on the samples' fixation. Soft fixation leads to slippage in the clamping, which reduces mechanical loading of the amnion layer and results in chorion rupturing first. Conversely, the stiffer, stronger, and less extensible amnion layer fails first if tight fixation is used. The results provide a novel insight into the interpretation of ex vivo testing as well as in vivo membrane rupture.

Do mechanical properties of human fetal membrane depend on strain rate?

AIM

The objective of this study was to examine the effect of strain rate on the mechanical properties of human fetal membranes.

METHODS

Different strain rates were employed to quantify the stress-strain relation of the chorioamnion membrane. The mechanical properties of nine human amnion membranes, four collected from cesarean delivery and five collected from normal vaginal delivery, were examined in uniaxial tension tests under strain rates of 0.1, 1 and 10%/min.

RESULTS

Statistical analysis revealed significant (P < 0.05) correlation between the change in strain rate and the elastic modulus as well as failure strain of amnion samples. The rupture stress, though, did not show dependency on strain rates.

CONCLUSION

Human chorioamnion is strongly viscoelastic. By increasing the rate of the test, the stiffness of amnion increases considerably.

Second harmonic generation microscopy of fetal membranes under deformation: normal and altered morphology

INTRODUCTION

Insight into the microstructure of fetal membrane and its response to deformation is important for understanding causes of preterm premature rupture of the membrane. However, the microstructure of fetal membranes under deformation has not been visualized yet. Second harmonic generation microscopy, combined with an in-situ stretching device, can provide this valuable information.

METHODS

Eight fetal membranes were marked over the cervix with methylene blue during elective caesarean section. One sample per membrane of reflected tissue, between the placenta and the cervical region, was cyclically stretched with a custom built inflation device. Samples were mounted on an in-situ stretching device and imaged with a multiphoton microscope at different deformation levels. Microstructural parameters such as thickness and collagen orientation were determined. Image entropy was evaluated for the spongy layer.

RESULTS

The spongy layer consistently shows an altered collagen structure in the cervical and cycled tissue compared with the reflected membrane, corresponding to a significantly higher image entropy. An increased thickness of collagenous layers was found in cervical and stretched samples in comparison to the reflected tissue. Significant collagen fibre alignment was found to occur already at moderate deformation in all samples.

CONCLUSIONS

For the first time, second harmonic generation microscopy has been used to visualize the microstructure of fetal membranes. Repeated mechanical loading was shown to affect the integrity of the amnion-chorion interface which might indicate an increased risk of premature rupture of fetal membrane. Moreover, mechanical loading might contribute to morphological alterations of the fetal membrane over the cervical region.