Addition of cervical elastography may increase preterm delivery prediction performance in pregnant women with short cervix

A prospective study

Korean Society of Ultrasound in Obstetrics and Gynecology Research Group

Research output: Contribution to journalArticle

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-Cervix TM (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.

Original languageEnglish
Article numbere68
JournalJournal of Korean medical science
Volume34
Issue number9
DOIs
Publication statusPublished - 2019 Mar 11

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Elasticity Imaging Techniques
Cervix Uteri
Pregnant Women
Prospective Studies
Area Under Curve
Elasticity
Pregnancy
Gestational Age
Korea
ROC Curve
Body Mass Index

Keywords

  • Elastography
  • Pregnancy
  • Preterm delivery
  • Short cervix
  • Strain
  • Ultrasonography

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Addition of cervical elastography may increase preterm delivery prediction performance in pregnant women with short cervix : A prospective study. / Korean Society of Ultrasound in Obstetrics and Gynecology Research Group.

In: Journal of Korean medical science, Vol. 34, No. 9, e68, 11.03.2019.

Research output: Contribution to journalArticle

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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-Cervix TM (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.",
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author = "{Korean Society of Ultrasound in Obstetrics and Gynecology Research Group} and Park, {Hyun Soo} and Hayan Kwon and Kwak, {Dong Wook} and Kim, {Moon Young} and Seol, {Hyun Joo} and Hong, {Joon Seok} and Shim, {Jae Yoon} and Choi, {Sae Kyung} and Hwang, {Han Sung} and Oh, {Min Jeong} and Geum-Joon Cho and Kunwoo Kim and Oh, {Soo Young}",
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T2 - A prospective study

AU - Korean Society of Ultrasound in Obstetrics and Gynecology Research Group

AU - Park, Hyun Soo

AU - Kwon, Hayan

AU - Kwak, Dong Wook

AU - Kim, Moon Young

AU - Seol, Hyun Joo

AU - Hong, Joon Seok

AU - Shim, Jae Yoon

AU - Choi, Sae Kyung

AU - Hwang, Han Sung

AU - Oh, Min Jeong

AU - Cho, Geum-Joon

AU - Kim, Kunwoo

AU - Oh, Soo Young

PY - 2019/3/11

Y1 - 2019/3/11

N2 - 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-Cervix TM (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.

AB - 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-Cervix TM (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.

KW - Elastography

KW - Pregnancy

KW - Preterm delivery

KW - Short cervix

KW - Strain

KW - Ultrasonography

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