Shear wave elastography: the relationship of the cervical stiffness with gestational age and cervical length- a feasibility study

Woo, Joyce; Ge, Weirong; Mancheri, Jyothi; Hyett, Jon; Mogra, Ritu

doi:10.1080/14767058.2022.2050896

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…Our study found a significant decrease in the mean CSWE score with advancing GA, which is consistent with the existing literature in both singleton and twin pregnancies 29,30 . Our finding that singleton pregnancies with sPTB have a significantly softer cervix before 25 weeks are consistent with a previous study on 628 singleton pregnancies, which demonstrated that a soft cervix identified at 18–24 weeks increased the risk of sPTB 16 .…”

Section: Discussionsupporting

confidence: 92%

Longitudinal evaluation of cervical length and shear wave elastography in women with spontaneous preterm birth

Nguyen‐Hoang,

Chaemsaithong,

Cheng

et al. 2024

Ultrasound in Obstet & Gyne

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ObjectivesTo compare longitudinal changes in cervical length (CL) and mean cervical shear wave elastography (CSWE) scores between women with singleton and twin pregnancies who experience spontaneous preterm birth (sPTB) and those who have term births (TB).MethodsThis was a prospective longitudinal study of 1264 unselected women with singleton (n=1143) and twin (n=121) pregnancy attending a dedicated research clinic for screening of sPTB at 4 timepoints during pregnancy including 11‐15+6 (visit 1), 16‐20+6 (visit 2), 21‐24+6 (visit 3) and 28‐32+6 (visit 4) weeks of gestation. At each visit, a transvaginal ultrasound scan was conducted to measure the CL and the CSWE scores from six regions of interest (ROI) (inner, middle, and external parts of anterior and posterior lips) in the cervix. The mean of CSWE scores from the six ROIs were calculated for data analysis. Log10 transformation was applied to make the data Gaussian prior to statistical analysis. A multilevel mixed‐effects analysis was performed to compare CL and CSWE longitudinally between sPTB and TB groups.ResultsA total of 57 (4.99%) singleton pregnancies and 33 (27.27%) twin pregnancies were complicated with sPTB. Women with sPTB had shorter CL across gestation when controlling for history of cervical surgery, number of fetuses, gestational age at cervical assessment (GA), and the interaction between GA and sPTB. CL in the sPTB group was significantly lower than that of the TB group at 21–24+6 weeks (p=0.039) and 28–32+6 weeks (p<0.001). Twin pregnancies had significantly longer CL throughout pregnancy, compared to singleton pregnancies (coefficient=0.01864, p<0.001). Furthermore, after adjusting for maternal age, weight, height, body mass index (BMI), and GA, CSWE scores in sPTB group were significantly lower in the sPTB group across gestation, compared to the TB group (1.28265 vs 1.32832; p=0.013). However, in the individual visit analysis, CSWE scores in the sPTB group were significantly lower than that of the TB group only at 11–15+6 weeks (p=0.013). There was no difference in CSWE scores between singleton and twin pregnancies throughout pregnancy (coefficient=‐0.00128, p=0.937).ConclusionWomen with sPTB have shorter CL and softer cervix across gestation when compared to those with TB. In the individual visit analysis, the reduction in CL in the sPTB group occurs from late second trimester onwards, while the reduction in cervical stiffness in the sPTB group is observed primarily in the first trimester. Additionally, our study has found that CL is significantly shorter in singleton pregnancies compared to twin pregnancies, while cervical stiffness does not differ between the two types of pregnancy. Our findings indicate that the cervix tends to undergo a softening process prior to shortening in the sPTB casesThis article is protected by copyright. All rights reserved.

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Section: Discussionsupporting

confidence: 92%

Longitudinal evaluation of cervical length and shear wave elastography in women with spontaneous preterm birth

Nguyen‐Hoang,

Chaemsaithong,

Cheng

et al. 2024

Ultrasound in Obstet & Gyne

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“…They showed that cervical elastosonography is a good predictor for preterm labor and cervical insufficiency [12][13][14]. In addition, studies have reported that cervical elastography performed during pregnancy shows cervical softening and maturation (especially in the internal cervical os) [15,16]. Yo et al performed weekly cervical elastography by starting at the 36th week on 238 pregnant women and found cervical elastography at the 39th gestational week to be useful to evaluate the time of delivery [17].…”

Section: Discussionmentioning

confidence: 99%

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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“…Briefly, using the E-Cervix TM program, the strain parameters of the internal os strain (IOS), external os strain (EOS), elasticity contrast index, IOS-to-EOS ratio, and hardness ratio can be measured after placing the region of interest caliper on the internal and external os and making the region of interest box include the entire cervix at the same mid-sagittal plane as the CL measurement with TVS [34]. Although some strain parameters measured using cervical elastography have shown significant associations with PTB [37][38][39], more prospective studies, including a standardized technique and beneficial management according to the findings, are needed before clinical application [40]. There are no clinical guidelines on the use of cervical elastography for cervical screening or management based on these results.…”

Section: Cervical Elastographymentioning

confidence: 99%

How to screen the cervix and reduce the risk of spontaneous preterm birth in asymptomatic women without a prior preterm birth

et al. 2023

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Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality globally. PTB rates have increased in South Korea despite reduction in birth rates. A history of PTB is a strong predictor of subsequent PTB and screening of cervical length between 16 0/7 weeks and 24 0/7 weeks of gestation is recommended in women with a singleton pregnancy and a prior spontaneous PTB. However, the prediction and prevention of spontaneous PTBs in women without a prior PTB remain a matter of debate. The scope of this review article comprises cervical screening and prevention strategies for PTB in asymptomatic women without a prior PTB, based on recent evidence and guidelines.

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Shear wave elastography: the relationship of the cervical stiffness with gestational age and cervical length- a feasibility study

Cited by 4 publications

References 29 publications

Longitudinal evaluation of cervical length and shear wave elastography in women with spontaneous preterm birth

Longitudinal evaluation of cervical length and shear wave elastography in women with spontaneous preterm birth

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

How to screen the cervix and reduce the risk of spontaneous preterm birth in asymptomatic women without a prior preterm birth

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