In-silico model of the pregnant uterus as a network of oscillators under sparse adaptive control

To ensure optimal survival of the neonate, the biological timing of parturition must be tightly controlled. Medical studies show that a variety of endocrine systems play the role of a control system, establishing a dynamic balance between the forces that cause uterine quiescence during pregnancy and the forces that produce coordinated uterine contractility at parturition. These control mechanism, and the factors that affect their performance, are still poorly understood. To help fill this gap, we propose a model of the pregnant uterus as a network of FitzHugh-Nagumo oscillators, with each cell symbolizing the electrical activity of a myocyte. The model is augmented with sparse adaptive control mechanisms representing the regulating endocrine functions. The control system is characterized by the fraction of controlled sites, and strength of control. We quantitatively find the conditions for which the control system exhibit a balance between robustness (resilience against perturbations) and flexibility (ability to switch function with minimal cost) crucial for optimal neonatal survival. Specifically, we show that Braxton-Hicks and Alvarez contractions, which are observed sporadic contractions of the uterine muscle, serve as a safety valve against over-controlling, strategically suppressed yet retained to optimize the control system's efficiency. Preterm birth is suggested to be understood as a mis-identification of the control boundaries. These insights contribute to advancing our understanding of maternal-fetal health.