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. 2021 Aug 12:12:587635.
doi: 10.3389/fphys.2021.587635. eCollection 2021.

A Review of Biomechanics Analysis of the Umbilical-Placenta System With Regards to Diseases

Shier Nee Saw  1 , Yichen Dai  1 , Choon Hwai Yap  2
Affiliations

A Review of Biomechanics Analysis of the Umbilical-Placenta System With Regards to Diseases

Shier Nee Saw et al. Front Physiol. .

Abstract

Placenta is an important organ that is crucial for both fetal and maternal health. Abnormalities of the placenta, such as during intrauterine growth restriction (IUGR) and pre-eclampsia (PE) are common, and an improved understanding of these diseases is needed to improve medical care. Biomechanics analysis of the placenta is an under-explored area of investigation, which has demonstrated usefulness in contributing to our understanding of the placenta physiology. In this review, we introduce fundamental biomechanics concepts and discuss the findings of biomechanical analysis of the placenta and umbilical cord, including both tissue biomechanics and biofluid mechanics. The biomechanics of placenta ultrasound elastography and its potential in improving clinical detection of placenta diseases are also discussed. Finally, potential future work is listed.

Keywords: biomechanics; elastography; fluid mechanics; placenta; tissue mechanics; umbilical cord.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Windkessel model/Lumped-parameter modeling consists of a resistor, which represents vascular resistance (R), and a capacitor, which represents vascular compliance (C). QR is the blood flow through the resistor, QC is the blood flow through the capacitor, ΔP is the pressure difference, dP/dt is the pressure change over time.
Figure 2
Figure 2
Biomechanics in umbilical arteries. (A) The flow resistance and wall shear stress (WSS) are affected by the umbilical coiling index (UCI) but not helical diameter. (B) Flow resistance and WSS disruption in helical geometry are lesser as compared to straight geometry, suggesting that the helical geometry of umbilical arteries aids in minimizing WSS disruption. This may indicate the existence of the WSS homeostasis mechanism in umbilical arteries for vascular growth (Saw et al., 2017). (C,D) IUGR umbilical arteries stretch lesser compared to control, indicating stiffer properties. The increased stiffness could be due to the increased collagen (red) and decreased elastin (green) contents shown by second-harmonic generation images (Dodson et al., 2013b). * indicates p < 0.0001.
Figure 3
Figure 3
Biomechanics of Wharton Jelly (WJ). WJ near placenta insertion showed lower Aggregate Modulus (HA) and Young Modulus (E), depicting non-homogeneous mechanical properties (Gervaso et al., 2014). * indicates p < 0.05.
Figure 4
Figure 4
Placental blood flow modeling. (A) WSS color contours on mouse placenta vasculature performed using CFD (Bappoo et al., 2017). (B) Blood flow streamlines and oxygen concentration field in the 2D placenta model (Lin et al., 2016).
Figure 5
Figure 5
Schematic diagram of quasi-static and dynamics elastography. Stiffness is represented by tissue deformation and propagation wave speed in quasi-static and dynamic elastography, respectively.
See this image and copyright information in PMC

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