Diagnostic accuracy of cervical elastography in predicting preterm delivery

Abstract

Background: The aim of the study was to evaluate the diagnostic accuracy of cervical elastography in predicting preterm delivery (PTD). Methods: We searched the PubMed, EMBASE, and Cochrane databases to identify relevant studies that applied ultrasound (US) elastography to assess cervical stiffness and predict PTD. All the studies were published before December 11, 2018, and only studies published in English were collected. The cervical length (CL) was considered a comparator, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was applied to assess the quality of the included studies. Summary receiver operating characteristic (SROC) modeling was performed to evaluate the diagnostic performance of cervical elastography in predicting PTD. Subgroup analyses were also performed. Results: Seven studies, including 1488 pregnant women, were included in this meta-analysis. Cervical elastography showed a summary sensitivity of 0.84 [95% confidence interval (CI): 0.68, 0.93], a specificity of 0.82 (95% CI: 0.63, 0.93), a diagnostic odds ratio of 25 (95% CI: 7, 93), and an area under the curve (AUC) of SROC of 0.90 (95% CI: 0.87–0.93). CL measurement showed that the AUC of SROC was 0.60 (95% CI: 0.56–0.64). The results of subgroup analysis showed that the summary sensitivity and specificity were different in the QUADAS-2 score subgroups. Conclusion: Cervical elastography is a promising and reliable method to predict PTD. Cervical elastography showed better diagnostic performance to predict PTD than CL measurement.

Cervical Assessment for Predicting Preterm Birth—Cervical Length and Beyond

“…A soft cervix (identified by shear-wave elastography) at 18-24 weeks of gestation increases the risk of sPTB <37 and <34 weeks of gestation independently of cervical length. Moreover, in a recent meta-analysis [75] of seven studies that included 1488 pregnant women, cervical elastography showed a sensitivity of 0.84 and a specificity of 0.82. The authors concluded that cervical elastography is a promising and reliable method to predict a PTB.…”

Shear Wave Dispersion as a Potential Biomarker for Cervical Remodeling During Pregnancy: Evidence From a Non-Human Primate Model

“…Various works have reported the use of the shear wave group speed V g as a surrogate for cervical softness in primates and humans [20,23,24,30,[55][56][57][58]. For example [59], reported a decrease in the group speed of shear waves between ripened and unripened ex vivo human cervical samples, 39% for the anterior region and 25% for the posterior region with a p value < 0.05.…”

Applications of Advanced Ultrasound Technology in Obstetrics

“…Allowing detection of changes in tissue elasticity, elastography is a complementary technique to B-mode imaging, and it includes two methods, namely, shear-wave and strain elastography. A recent meta-analysis showed that the performance of cervical elastography was better than cervical length in the prediction of preterm delivery [ 37 ]. For the prediction of outcome of induction of labor, models based on inner cervical shear wave elastography and cervical length were more accurate than models based on the Bishop score [ 38 ].…”