美国国家公共电台 NPR Scientific Duo Gets Back To Basics To Make Childbirth Safer

 

DAVID GREENE, HOST:

This is the story about two women, a doctor and a mechanical engineer. They came together to study one of the most basic parts of human life - pregnancy¹ and labor². That's because there's a lot we just don't know. NPR's Alison Kodjak reports on this unusual pair of researchers who are trying to learn more.

ALISON KODJAK, BYLINE³: Dr. Joy Vink deals only with the hardest cases, cases like that of Brittney Crystal. Crystal was under Vink's care when she went into labor at just 28 weeks pregnant. She was rushed into an operating room at Columbia University Medical Center for an emergency C-section to try to save her baby, whom she had already named Iris⁴.

BRITTNEY CRYSTAL: And I think I knew before I opened my eyes that she had died.

KODJAK: Afterward⁵, as she was recovering in the hospital and mourning the loss of Iris, Crystal and her family asked Dr. Vink why there was no way to stop the premature⁶ labor.

CRYSTAL: And that's when Dr. Vink told us that actually, you know, rare diseases are being cured in this day and age, but we don't know what triggers full-term labor, which I think just collectively blew away everyone in the room.

KODJAK: Vink runs the Preterm Birth Prevention Center at Columbia. She says when it comes to pregnancy, basic research stalled decades ago. If a pregnancy is normal, that's not all that important. But when things go wrong, she says those gaps in knowledge become issues of life and death.

JOY-SARAH VINK: It's heartbreaking. It's heartbreaking to see patients who, either on their first or on their third, fourth, fifth time around, are losing a pregnancy right at that cusp of viability⁷.

KODJAK: Crystal had what was called a short cervix, which put her at risk for going into labor early. She'd had a procedure called a cerclage, which is basically a stitch in her cervix to keep it closed and prevent an early birth. The technique has been around for more than 50 years. And while there's research to show it may help, the information is limited. Most of the basic knowledge about pregnancy comes from research performed in the 1940s, so Vink decided⁸ this time to learn more. She's starting by getting to know the cervix.

VINK: So what is the cervix made out of? What proteins are there? What cells are there? How are all these things interacting? How go they change in pregnancy? How does the cervix go from a stiff, sort of strong structure that's like the consistency⁹ of the tip of your nose to something that's as soft as butter by the end of pregnancy?

KODJAK: Her lab is full of graduate students.

VINK: We actually are taking tissue samples from the cervix from non-pregnant women as well as in pregnancy to understand what is a tissue made out of.

KODJAK: And while she's figuring out what it's made out of, she's teamed up with someone who can figure out what it can do - Kristin Myers.

KRISTIN MYERS: I'm kind of a oddball here in the Department of Obstetrics and Gynecology. I'm a mechanics person. I teach mechanics classes and design classes.

KODJAK: Myers got her start doing undergraduate research in the automobile¹⁰ industry looking at how rubber and tires degrades.

MYERS: So if you take rubber, and you heat it up, and you pull on it, it gets really, really soft. And then it breaks.

KODJAK: Her advisor¹¹ suggested she could apply that kind of research to biology. And when she got to graduate school at MIT, she met Michael House, who was studying the biomechanics of pregnancy.

MICHAEL HOUSE: It's an important area, an understudied area and a basic part of pregnancy physiology¹². And I think that there's just lots to learn.

KODJAK: House, who's at Tufts, also has a background in engineering. He became a mentor¹³ to Myers and continues to collaborate¹⁴ with her today. He says Myers' and Vink's research on the cervix is particularly important.

HOUSE: A cervix problem is a tough one because a cervix problem can affect the pregnancy very early.

KODJAK: That means women with cervix problems are more likely to miscarry or give birth so early that their babies may die or face lifelong health problems. House says nailing down the mechanics of pregnancy is crucial to reducing premature birth. So Myers is laying the foundation - how much the uterus can stretch, how much pressure is on the cervix, what makes it open, how much force a baby's kick puts on the whole system. She has a lab next to Vink's at the medical center and another at Columbia's engineering school.

MYERS: So here's my lab.

KODJAK: There are four students sitting elbow to elbow at computers.

MYERS: So here in New York City, we run a tight, efficient ship. This is a 600-square-feet biomechanics lab.

KODJAK: On one screen, there's a multicolored three-dimensional image of the cervix that changes as the researchers add variables like a baby's kick. On the other side of a partition, there are microscopes and scalpels and slides.

MYERS: On this bench over here is a contraption we made to mechanically test thin membranes¹⁵.

KODJAK: The machine inflates¹⁶ uterine membranes like a balloon. And there's another machine about the size of a microwave that stretches cervical tissue between two tiny grips.

MYERS: In civil engineering, you can have one of these machines that is, like, two, three stories high. And they're testing the mechanical strength of, like, railroad ties.

KODJAK: One of the most remarkable¹⁷ things about the cervix, Myers says, is how much it changes during pregnancy. Remember nose to butter?

MYERS: Pregnant tissue is really, really soft and squishy. So we've mechanically tested various pregnant tissues and non-pregnant tissues of the cervix, and its stiffness changes by three orders of magnitude.

KODJAK: Myers is also building an entirely¹⁸ new database of the anatomy¹⁹ of pregnant women using ultrasound images that measure the baby and the mother throughout pregnancy. She says she got the idea when she was pregnant and getting an ultrasound herself.

MYERS: Laying there on the bench, I was like, well, why can't we just measure the mom more?

KODJAK: The plan is to use that data to create a model that can predict how the uterus and cervix will react to various forces.

MYERS: What if the baby's kicking rigorously? How much mechanical force does it put on? What if the woman's at bed rest? How much does that take gravity off of her cervix? And, you know, we just don't know.

KODJAK: Vink and Myers are in constant contact. Myers' students observe Vink in the operating room as she collects tissue samples, and Vink reviews Myers' computer simulations. Their goal? To be able to look at a pregnant woman and predict accurately²⁰ if she will go into labor prematurely²¹. Only then can doctors find reliable interventions²² to stop it, which is what Brittney Crystal is aiming for as well. After Iris died, Crystal started a foundation called The Iris Fund, which has raised more than $150,000 for Vink's and Myers' research.

CRYSTAL: She didn't get to have a life, but we really want her to have a very strong legacy²³.

KODJAK: Alison Kodjak, NPR News, New York.

(SOUNDBITE OF DO MAKE SAY THINK'S "HERSTORY OF GLORY")

1 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

2 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

3 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

4 iris   

n.虹膜，彩虹

参考例句：

• The opening of the iris is called the pupil.虹膜的开口处叫做瞳孔。
• This incredible human eye,complete with retina and iris,can be found in the Maldives.又是在马尔代夫，有这样一只难以置信的眼睛，连视网膜和虹膜都刻画齐全了。

5 afterward   

adv.后来；以后

参考例句：

• Let's go to the theatre first and eat afterward. 让我们先去看戏，然后吃饭。
• Afterward,the boy became a very famous artist.后来，这男孩成为一个很有名的艺术家。

6 premature   

adj.比预期时间早的；不成熟的，仓促的

参考例句：

• It is yet premature to predict the possible outcome of the dialogue.预言这次对话可能有什么结果为时尚早。
• The premature baby is doing well.那个早产的婴儿很健康。

7 viability   

n.存活(能力)

参考例句：

• What is required to achieve or maintain such viability? 要达到或维持这种生存能力需要什么？
• Scientists are experimenting to find ways to ensure the viability of seeds for even longer periods of time. 正如我们所说，科学家正在试验努力寻找让种子的生命力更加延长的方法。

8 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

9 consistency   

n.一贯性，前后一致，稳定性；(液体的)浓度

参考例句：

• Your behaviour lacks consistency.你的行为缺乏一贯性。
• We appreciate the consistency and stability in China and in Chinese politics.我们赞赏中国及其政策的连续性和稳定性。

10 automobile   

n.汽车，机动车

参考例句：

• He is repairing the brake lever of an automobile.他正在修理汽车的刹车杆。
• The automobile slowed down to go around the curves in the road.汽车在路上转弯时放慢了速度。

11 advisor   

n.顾问，指导老师，劝告者

参考例句：

• They employed me as an advisor.他们聘请我当顾问。
• The professor is engaged as a technical advisor.这位教授被聘请为技术顾问。

12 physiology   

n.生理学，生理机能

参考例句：

• He bought a book about physiology.他买了一本生理学方面的书。
• He was awarded the Nobel Prize for achievements in physiology.他因生理学方面的建树而被授予诺贝尔奖。

13 mentor   

n.指导者，良师益友；v.指导

参考例句：

• He fed on the great ideas of his mentor.他以他导师的伟大思想为支撑。
• He had mentored scores of younger doctors.他指导过许多更年轻的医生。

14 collaborate   

vi.协作，合作；协调

参考例句：

• The work gets done more quickly when we collaborate.我们一旦合作，工作做起来就更快了。
• I would ask you to collaborate with us in this work.我们愿意请你们在这项工作中和我们合作。

15 membranes   

n.（动物或植物体内的）薄膜( membrane的名词复数 )；隔膜；（可起防水、防风等作用的）膜状物

参考例句：

• The waste material is placed in cells with permeable membranes. 废液置于有渗透膜的槽中。 来自辞典例句
• The sarcoplasmic reticulum is a system of intracellular membranes. 肌浆网属于细胞内膜系统。 来自辞典例句

16 inflates   

v.使充气（于轮胎、气球等）( inflate的第三人称单数 )；（使）膨胀；（使）通货膨胀；物价上涨

参考例句：

• Mass advertising often inflates prices rather than reducing them. 大宗广告常常是抬高物价而不是降低。 来自辞典例句
• The device periodically inflates the cuff and takes a blood pressure reading. 定期气囊打气及进行血压读数。 来自互联网

17 remarkable   

adj.显著的，异常的，非凡的，值得注意的

参考例句：

• She has made remarkable headway in her writing skills.她在写作技巧方面有了长足进步。
• These cars are remarkable for the quietness of their engines.这些汽车因发动机没有噪音而不同凡响。

18 entirely   

ad.全部地，完整地；完全地，彻底地

参考例句：

• The fire was entirely caused by their neglect of duty. 那场火灾完全是由于他们失职而引起的。
• His life was entirely given up to the educational work. 他的一生统统献给了教育工作。

19 anatomy   

n.解剖学，解剖；功能，结构，组织

参考例句：

• He found out a great deal about the anatomy of animals.在动物解剖学方面，他有过许多发现。
• The hurricane's anatomy was powerful and complex.对飓风的剖析是一项庞大而复杂的工作。

20 accurately   

adv.准确地，精确地

参考例句：

• It is hard to hit the ball accurately.准确地击中球很难。
• Now scientists can forecast the weather accurately.现在科学家们能准确地预报天气。

21 prematurely   

adv.过早地，贸然地

参考例句：

• She was born prematurely with poorly developed lungs. 她早产，肺部未发育健全。 来自《简明英汉词典》
• His hair was prematurely white, but his busy eyebrows were still jet-black. 他的头发已经白了，不过两道浓眉还是乌黑乌黑的。 来自辞典例句

22 interventions   

n.介入，干涉，干预( intervention的名词复数 )

参考例句：

• Economic analysis of government interventions deserves detailed discussion. 政府对经济的干预应该给予充分的论述。 来自辞典例句
• The judge's frequent interventions made a mockery of justice. 法官的屡屡干预是对正义的践踏。 来自互联网

23 legacy   

n.遗产，遗赠；先人(或过去)留下的东西

参考例句：

• They are the most precious cultural legacy our forefathers left.它们是我们祖先留下来的最宝贵的文化遗产。
• He thinks the legacy is a gift from the Gods.他认为这笔遗产是天赐之物。