title: Magnetic resonance imaging of the cervix in women at high risk for preterm delivery.
abstract: OBJECTIVE
  To assess whether changes in signal intensity of cervical stroma layers on magnetic resonance imaging (MRI) are associated with spontaneous preterm delivery.
  
  
  METHODS
  Prospective cohort study of women admitted for threatened late miscarriage or preterm delivery between 18 and 34 weeks of gestation. We performed T2-weighted low-field MRI of the uterine cervix among 100 women. Cervical stromal differentiation, defined as the contrast between signal intensities of the inner and outer cervical layers, was classified as high, intermediate, or low by a radiologist blinded to the participant's clinical report. The main outcome measure was the proportion of spontaneous preterm delivery.
  
  
  RESULTS
  Thirty-six women had a spontaneous preterm delivery. The proportion of spontaneous preterm delivery for high, intermediate, and low stromal differentiation was 7/24 (29%), 21/64 (33%; risk ratio 1.1; 95% confidence interval [CI]: 0.6-2.3), and 8/12 (67%; risk ratio 2.3; 95% CI: 1.1-4.8), respectively. The risk of delivering within 7 days increased when stromal differentiation decreased, although the difference was not statistically significant.
  
  
  CONCLUSIONS
  The risk of spontaneous preterm delivery is increased in women with low cervical stromal differentiation on MRI. This risk is also associated with short cervical length, a measurement easier and less costly to obtain by transvaginal ultrasound.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland. Begona.mdt@bluewin.ch
authors.forename: Begoña Martinez
authors.initials: BM
authors.lastname: de Tejada
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Faltin
authors.forename: Karen
authors.initials: K
authors.lastname: Kinkel
authors.forename: Marie-Julia
authors.initials: MJ
authors.lastname: Guittier
authors.forename: Michel
authors.initials: M
authors.lastname: Boulvain
authors.forename: Olivier
authors.initials: O
authors.lastname: Irion
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000473:pathology; D005865:Gestational Age; D006801:Humans; D008279:Magnetic Resonance Imaging; D007752:Obstetric Labor, Premature / Q000473:pathology; D010298:Parity; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D047928:Premature Birth / Q000473:pathology*; D011446:Prospective Studies