Addition of Cervical Elastography May Increase Preterm Delivery Prediction Performance in Pregnant Women with Short Cervix: a Prospective Study
- Author:
Hyun Soo PARK
1
;
Hayan KWON
;
Dong Wook KWAK
;
Moon Young KIM
;
Hyun Joo SEOL
;
Joon Seok HONG
;
Jae Yoon SHIM
;
Sae Kyung CHOI
;
Han Sung HWANG
;
Min Jeong OH
;
Geum Joon CHO
;
Kunwoo KIM
;
Soo young OH
;
Author Information
- Publication Type:Original Article
- Keywords: Short Cervix; Elastography; Strain; Preterm Delivery; Ultrasonography; Pregnancy
- MeSH: Area Under Curve; Body Mass Index; Cervix Uteri; Elasticity; Elasticity Imaging Techniques; Female; Gestational Age; Humans; Pregnancy; Pregnant Women; Prevalence; Prospective Studies; ROC Curve; Seoul; Ultrasonography
- From:Journal of Korean Medical Science 2019;34(9):e68-
- CountryRepublic of Korea
- Language:English
- 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.
