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

• DOI: 10.3346/jkms.2019.34.e68
• Publication Date: 2019-03-04T08:52:46Z
• Authors: Hyun Soo Park; 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
• Keywords: Adult; Gestational Age; Cervix Uteri; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Pregnancy; Area Under Curve; Republic of Korea; Prevalence; Elasticity Imaging Techniques; Humans; Premature Birth; Original Article; Female; Prospective Studies

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-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.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).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.