**4.3 Anatomical computer simulation models to study human cervix uteri remodeling**

The unanswered questions on premature CR, and sPTB prediction wait for answers from anatomically correct computer simulation models of pregnant human pelvis, uterus, and cervix geometry. The stress/stretch amount on the IO area depends on cervix angle/position in the pelvis [10] and on amniotic membrane strength, assessed by 3D MRI [24]. Vink and Feltovich [4] elaborated on the hypothesis that combining weak membranes to an undesirable cervical position/ angle that increases the stretch on IO ultimately leads to cervical dilation and sPTB. The engineering tools will help to evaluate/predict sPTB using computational biomechanics and finite element analysis to study sPTB causes and to develop a diagnosis tool for outcome prediction [110]. One may individualize the computer models (which incorporate patient-specific tissue properties and ultrasoundderived parameters) to predict and/or identify which women with premature CR will deliver preterm.
