Quantitative sonoelastography of the uterine cervix by interposition of a synthetic reference material

Hee, Lene; Sandager, Puk; Petersen, Olav Bjørn; Uldbjerg, Niels

doi:10.1111/aogs.12246

Cited by 34 publications

(23 citation statements)

References 15 publications

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“…Interesting is the approach proposed by the Danish group, which proposed to overcome the problem of the exerted force by positioning a reference cup with known Young's modulus on the vaginal probe [42]. Even though the potential advantage of calculating the exact elasticity coefficient of the cervix method should be better standardized as the authors report a good intra-observer intra-class correlation, but a quite poor inter-observer intra-class correlation [20].…”

Section: The Type Of Elastographic Methods Usedmentioning

confidence: 99%

Diagnostic accuracy of cervical elastography in predicting labor induction success: a systematic review and meta-analysis

Londero¹,

Schmitz

Bertozzi

et al. 2016

Journal of Perinatal Medicine

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Aim: To determine the accuracy of cervical elastography in predicting labor induction success. Materials and methods: A systematic search, review, and meta-analysis of observational studies published in English language between January 2000 and October 2014 was performed. It included studies considering cervix sonoelastography as the index test and successful labor or vaginal delivery as the reference standard. As cervix length and Bishop score were considered comparator tests, the quality of the included studies was assessed using quality assessment tool for diagnostic accuracy studies (QUADAS) tool. Results: A total of four studies assessing 323 women before medical induction of labor were included. Cervical elastography, cervical length, and Bishop score showed a diagnostic odds ratio (DOR) with 95% confidence interval (CI) for successful labor prediction of 3.50 (1.93-6.35), 3.35 (1.94-5.77), and 1.45 (0.33-6.41), respectively. In addition, cervical elastography, cervical length, and Bishop score showed a DOR with 95% CI for successful vaginal delivery prediction of 5. 24 (3.23-8.50), 4.94 (2.72-8.98), and 4.62 (0.69-30.94), respectively. Considering the summary of receiver operating characteristic curves we show that cervical elastography or length are similarly reliable, and both are more reliable to predict successful labor than the Bishop score. Two studies were excluded because it was not possible to retrieve data for the meta-analysis. Among the excluded studies, one found no significant contribution from elastography for prediction of successful labor induction. Conclusions: Even though there is a limited number of studies included and the heterogeneity of the methods used, cervical elastography seems to be a promising tool for predicting successful labor induction and vaginal delivery in women treated by medical induction of labor.

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Section: The Type Of Elastographic Methods Usedmentioning

confidence: 99%

Diagnostic accuracy of cervical elastography in predicting labor induction success: a systematic review and meta-analysis

Londero¹,

Schmitz

Bertozzi

et al. 2016

Journal of Perinatal Medicine

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“…Molina et al noted no statistically significant differences between cervices except in the precise area that received the force from the transducer. Various approaches are currently being employed to address this problem of transducer force standardization (Fruscalzo et al, 2015; Hee et al, 2013; Hernandez-Andrade et al, 2014). …”

Section: Cervical Tissue Mechanical Propertiesmentioning

confidence: 99%

The mechanical role of the cervix in pregnancy

Myers

Feltovich

Mazza

et al. 2015

Journal of Biomechanics

183

158

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Appropriate mechanical function of the uterine cervix is critical for maintaining a pregnancy to term so that the fetus can develop fully. At the end of pregnancy, however, the cervix must allow delivery, which requires it to markedly soften, shorten and dilate. There are multiple pathways to spontaneous preterm birth, the leading global cause of death in children less than 5 years old, but all culminate in premature cervical change, because that is the last step in the final common pathway to delivery. The mechanisms underlying premature cervical change in pregnancy are poorly understood, and therefore current clinical protocols to assess preterm birth risk are limited to surrogate markers of mechanical function, such as sonographically measured cervical length. This is what motivates us to study the cervix, for which we propose investigating clinical cervical function in parallel with a quantitative engineering evaluation of its structural function. We aspire to develop a common translational language, as well as generate a rigorous integrated clinical-engineering framework for assessing cervical mechanical function at the cellular to organ level. In this review, we embark on that challenge by describing the current landscape of clinical, biochemical, and engineering concepts associated with the mechanical function of the cervix during pregnancy. Our goal is to use this common platform to inspire novel approaches to delineation of normal and abnormal cervical function in pregnancy.

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“…The technique with the probe reference ‘cap’ has shown promise before in clinic applications (for example, Hee et al 2013 and 2014). The present study used a similar technique to measure the modulus of the perineal body, an important anatomical structure that is widely discussed in the gynecology and obstetrics literature but rarely studied.…”

Section: Discussionmentioning

confidence: 99%

In vivo estimation of perineal body properties using ultrasound quasistatic elastography in nulliparous women

Chen

Low

DeLancey

et al. 2015

Journal of Biomechanics

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Objective The perineal body must undergo a remarkable transformation during pregnancy to accommodate an estimated stretch ratio of over 3.3 in order to permit vaginal delivery of the fetal head. Yet measurements of perineal body elastic properties are lacking in vivo, whether in the pregnant or non-pregnant state. The objective of this study, therefore, was to develop a method for measuring perineal body elastic modulus and to test its feasibility in young nulliparous women. Methods An UltraSONIX RP500 ultrasound system was equipped with elastography software. Approximately 1 Hz free-hand sinusoidal compression loading of the perineum was used to measure the relative stiffness of the perineal body compared to that of a custom reference standoff pad with a modulus of 36.7 kPa. Measurements were made in 20 healthy nulliparous women. Four subjects were invited back for second and third visits to evaluate within- and between-visit repeatability using the coefficient of variation. Results The mean± SD elastic compression modulus of the perineal body was 28.9 ± 4.7 kPa. Within- and between-visit repeatability averaged 3.4% and 8.3%, respectively. Conclusion Ultrasound elastography using a standoff pad reference provides a valid method for evaluating the elastic modulus of the perineal body in living women.

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Quantitative sonoelastography of the uterine cervix by interposition of a synthetic reference material

Cited by 34 publications

References 15 publications

Diagnostic accuracy of cervical elastography in predicting labor induction success: a systematic review and meta-analysis

Diagnostic accuracy of cervical elastography in predicting labor induction success: a systematic review and meta-analysis

The mechanical role of the cervix in pregnancy

In vivo estimation of perineal body properties using ultrasound quasistatic elastography in nulliparous women

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