Oral Concurrent Session 7 - Basic and Translational Science
Oral Concurrent Sessions
Sohum C. Shah, MD (he/him/his)
MFM Fellow
Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
UCLA, California, United States
Haley Marks, PhD
University of California, Los Angeles (UCLA)
UCLA, California, United States
Guadalupe Martinez, BS, MPH
University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Jakub Staniczek, MD, PhD
Assistant Professor
Śląski Uniwersytet Medyczny w Katowicach
Katowice, Slaskie, Poland
Alex Kot, PhD
University of California, Los Angeles (UCLA)
UCLA, California, United States
Roya Bagheri, PhD
Postdoctoral employee
University of California, Los Angeles (UCLA)
UCLA Health, California, United States
Deborah Krakow, MD
Professor and Chair
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Yalda Afshar, MD, PhD (she/her/hers)
David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Our previous data demonstrated aberrant type I collagen architecture at the site of placental adherence in PAS. Despite the clinical significance of PAS, prevention strategies are limited, with cesarean scar optimization representing an unmet clinical need. PAS results from abnormal trophoblast adherence at a uterine scar. We developed a novel second-harmonic generation (SHG) imaging protocol to quantify collagen architecture in collagen-deficient and wild-type (WT) murine uteri with and without PAS, establishing the foundation for collagen-based PAS prevention therapies at the cesarean scar.
Study Design:
Type I collagen mutant mice were utilized (Col1a1+/- and Col1a1aga2 heterozygous) and compared to WT controls. Uteri and cervix were processed for en bloc SHG imaging followed by 20× sectional analysis. Blinded quantitative analysis assessed collagen density (fibrillar:background intensity ratio) across the cervix, proximal, and distal uterine regions. Statistical analysis used Mann-Whitney U test with significance set at p< 0.05 and two-way ANOVA with significance set at p< 0.05.
Results:
WT demonstrated 3.2x higher collagen density versus mutants (mean ratio 2.85±0.34 vs 0.89±0.21,p< 0.001(Fig 1). Regional analysis revealed a distinct anatomical gradient: cervix(3.1±0.4),proximal horn(2.2±0.3),distal horn(1.8±0.2). Collagen organization differed markedly, with WT showing dense reticular networks versus sparse fibers in mutants(Fig 2). The cell-cell adhesion molecule and extracellular matrix component, E-cadherin, co-localized with Type I collagen. PAS mice demonstrate disturbed collagen organization at the decidual-placental border.
Conclusion:
This validated SHG protocol enables precise collagen quantification and reveals critical regional variations in uterine architecture. This directly informs collagen-restoration strategies for PAS prevention, with utero-cervical junction targeting representing the highest-yield intervention site. Translation to mouse PAS models and human cesarean scar assessment represents the immediate next step.