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J Korean Med Sci. 2019 Feb 27;34(9):e68. doi: 10.3346/jkms.2019.34.e68. eCollection 2019 Mar 11.

Addition of Cervical Elastography May Increase Preterm Delivery Prediction Performance in Pregnant Women with Short Cervix: a Prospective Study.

Author information

1
Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, Korea.
2
Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
3
Department of Obstetrics and Gynecology, Ajou University Hospotal, Ajou University School of Medicine, Suwon, Korea.
4
Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
5
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
6
Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
7
Department of Obstetrics and Gynecology, The Catholic University of Korea Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
8
Department of Obstetrics and Gynecology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
9
Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
10
Department of Obstetrics and Gynecology, Hamchoon Women's Clinic, Seoul, Korea.
11
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

Background:

We investigated whether there is a difference in elastographic parameters between pregnancies with and without spontaneous preterm delivery (sPTD) in women with a short cervix (≤ 25 mm), and examined the ability of elastographic parameters to predict sPTD in those women.

Methods:

E-CervixTM (WS80A; Samsung Medison, Seoul, Korea) elastography was used to examine the cervical strain. Elastographic parameters were compared between pregnancies with and without sPTD. Diagnostic performance of elastographic parameters to predict sPTD ≤ 37 weeks, both alone and in combination with other parameters, was compared with that of cervical length (CL) using area under receiver operating characteristic curve (AUC) analysis.

Results:

A total of 130 women were included. Median gestational age (GA) at examination was 24.4 weeks (interquartile range, 21.4-28.9), and the prevalence of sPTD was 20.0% (26/130). Both the elastographic parameters and CL did not show statistical difference between those with and without sPTD. However, when only patients with CL ≥ 1.5 cm (n = 110) were included in the analysis, there was a significant difference between two groups in elasticity contrast index (ECI) within 0.5/1.0/1.5 cm from the cervical canal (P < 0.05) which is one of elastographic parameters generated by E-Cervix. When AUC analysis was performed in women with CL ≥ 1.5 cm, the combination of parameters (CL + pre-pregnancy body mass index + GA at exam + ECI within 0.5/1.0/1.5 cm) showed a significantly higher AUC than CL alone (P < 0.05).

Conclusion:

An addition of cervical elastography may improve the ability to predict sPTD in women with a short CL between 1.5 and 2.5 cm.

KEYWORDS:

Elastography; Pregnancy; Preterm Delivery; Short Cervix; Strain; Ultrasonography

PMID:
30863266
PMCID:
PMC6406042
DOI:
10.3346/jkms.2019.34.e68
[Indexed for MEDLINE]
Free PMC Article

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