Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour

Strobel, Marlit Karen; Eveslage, Maria; Köster, Helen Ann; Möllers, Mareike; Braun, Janina; Santis, Chiara De; Oelmeier, Kathrin; Klockenbusch, Walter; Schmitz, Ralf

doi:10.1515/jpm-2020-0189

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…However, there are still conflicts in studies investigating the role of cervical elastosonography in predicting the success of labor induction. Strobel et al could not prove the relationship of elastography for the prediction of successful labor induction [20].…”

Section: Discussionmentioning

confidence: 98%

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Halilzade

HALİLZADE

Sert

et al. 2023

Z Geburtshilfe Neonatol

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ObjectiveWe aimed to show whether elastography can be analternative, although the Bishop score used in the follow-up of labor induction success with oxytocin is a relative concept. Material and methods This prospective case-control study includes 56 cases admitted to a tertiary maternity hospital for induction between March and June 2019. Cervical elastography was applied to patients before induction. Induction success in pregnant women who underwent induction with oxytocin was accepted to be greater than Bishop 9. The cases were divided into two groups as successful (n=28) and unsuccessful (n=28) induction, and their elastosonographic findings were compared. ResultsIn 28 cases with successful induction (Bishop >9, and vaginal delivery occurred in 28), the mean stiffness of the cervix in measurements from four regions was 13.6 ±3.7 kPa in the measurement of the cervix with the elastography method before induction was started, while this value was measured as 14.9 ± 3.1 in cases where induction was unsuccessful (t- value: -1.321, p=0.194). Conclusions Our study showed that pre-induction stiffness of the cervix cannot predict the success of labor induction with oxytocin. More studies with larger samples are needed to arrive at a decent conclusion. In addition, results can be more assuring with the developing technique and sensitivity of elastography.

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Section: Discussionmentioning

confidence: 98%

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Halilzade

HALİLZADE

Sert

et al. 2023

Z Geburtshilfe Neonatol

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“…However, the outcomes of IOL used in these studies are different which makes the results hard to compare. Other studies favouring cervical elastography as a tool to predict outcome of labour include those conducted by Zhou et al, 1 Strobel et al, 18 Londero 19 and Fruscalzo et al 20 Sonnier et al 21 and Pereira et al 22 however did not find cervical elastography useful in predicting delivery.…”

Section: Discussionmentioning

confidence: 99%

Quantitative sonoelastography of the uterine cervix in predicting successful outcome of induction of labour

et al. 2023

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Objectives: The aim of the study was to evaluate the stiffness of cervix and determine its significance in predicting successful outcome of induction of labour. The primary objective was to determine the differences in elastography indices of different areas of cervix between the outcome groups of successful and failed induction of labour. A secondary objective was to find out the correlation of these elastography indices with Bishop’s score and cervical length. Methods: This was a prospective, observational study conducted over a period of 6 months on pregnant women admitted in the labour room for induction of labour. Establishment of adequate regular uterine contractions – at least three contractions lasting 40–45 s in a 10-min period – was taken as end point for successful outcome of induction of labour. Even after 24 h of initiation of induction of labour, regular, adequate and painful uterine contractions were not established, then induction of labour was described as having failed. Prior to induction, cervical length measurement, Bishop’s scoring and elastographic evaluation of the cervix were done by stress–strain elastography. A colour map was produced from purple to red and a five-step scale – the elastography index – was used to describe the various parts of the cervix. The differences between elastography indices of different parts of cervix were estimated using Mann–Whitney U test. Correlation of the indices with cervical length and Bishop’s score was determined by Spearman’s correlation coefficient. Results: A total of 64 women were included in the study. A significant difference ( p < 0.001) was found in the elastography index of internal os between the two outcome groups of success (1.76 ± 0.64) and failure (0.54 ± 0.18). However, the elastography index of central cervical canal, external os, anterior lip and posterior lips did not differ significantly across the outcome groups. A significant positive correlation was found between elastography index of internal os and cervical length (Spearman’s correlation coefficient, r = 0.441, p < 0.001) and between elastography index of external os and cervical length ( r = 0.347, p = 0.005), whereas a negative correlation was seen between elastography index of external os and Bishop’s score ( r = −0.270, p = 0.031). Conclusion: Elastography index of internal os can be used to predict outcome of induction of labour. Cervical elastography is a promising new technique for cervical consistency assessment. Further larger studies are required to determine some cut-off point for elastography index of internal os in prediction of outcome of induction of labour and to strongly establish the usefulness of cervical elastography for pregnancy management, preventing preterm delivery and establishment of cut-off points to determine successful induction.

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“…Strobel et al included 41 full-term pregnancies who decided to accept IOL and SE, and assessments of the Bishop score were performed before and 3 h after IOL. They observed an association between strain patterns and SR values at 3 h after IOL and a successful IOL ( p = 0.0343 and p = 0.0342, respectively) that the results can well demonstrate after 48 h. This is the first study to demonstrate that cervical SE after the first application of prostaglandins helps predict the outcome of IOL [ 77 ]. Another study reported that measurement by SE is relatively reproducible with intra-observer reproducibility ICC 0.733 (95% CI 0.553–0.841) and inter-observer reproducibility ICC 0.801 (95% CI 0.666–0.881) [ 78 ].…”

Section: Predicting Preterm Deliverymentioning

confidence: 94%

Advances in the clinical application of ultrasound elastography in uterine imaging

Wang

Lin

2022

Insights Imaging

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Changes in tissue stiffness by physiological or pathological factors in tissue structure are identified earlier than their clinical features. Pathological processes such as uterine fibrosis, adenomyosis, endometrial lesions, infertility, and premature birth can manifest as tissue elasticity changes. In clinical settings, elastography techniques based on ultrasonography, optical coherence tomography, and magnetic resonance imaging are widely used for noninvasive measurement of mechanical properties in patients, providing valuable tool and information for diagnosis and treatment. Ultrasound elastography (USE) plays a critical role in obstetrics and gynecology clinical work because of its simplicity, non-invasiveness, and repeatability. This article reviews the recent progress of USE in uterine tumor diagnosis (especially early diagnosis and treatment effect evaluation), prediction of preterm birth, and intrauterine insemination. We believe that USE, especially shear wave elastography, may serve as a potential means to assess tissue stiffness, thereby improving the diagnosis and treatment of adenomyosis, fibroids, endometrial lesions, cervical cancer, and precise management of preterm birth and intrauterine insemination monitoring.

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Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour

Cited by 6 publications

References 28 publications

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Quantitative sonoelastography of the uterine cervix in predicting successful outcome of induction of labour

Advances in the clinical application of ultrasound elastography in uterine imaging

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