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

• Published in: Journal of Korean medical science Vol. 34; no. 9; pp. e68 - 14
• Main Authors: Park, Hyun Soo, Kwon, Hayan, Kwak, Dong Wook, Kim, Moon Young, Seol, Hyun-Joo, Hong, Joon-Seok, Shim, Jae-Yoon, Choi, Sae-Kyung, Hwang, Han-Sung, Oh, Min Jeong, Cho, Geum Joon, Kim, Kunwoo, Oh, Soo-Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 11.03.2019; 대한의학회
• Subjects: Adult; Area Under Curve; Cervix Uteri - diagnostic imaging; Cervix Uteri - physiology; Elasticity Imaging Techniques; Female; Gestational Age; Humans; Original; Pregnancy; Premature Birth - diagnosis; Premature Birth - epidemiology; Prevalence; Prospective Studies; Republic of Korea - epidemiology; ROC Curve; 의학일반; Republic of Korea; Pregnancy; Short Cervix; Elastography; Ultrasonography; Preterm Delivery; Strain
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2019.34.e68

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. E-Cervix (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. 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 ( < 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 ( < 0.05). 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.