title: Myometrial elasticity determined by elastosonography to predict preterm labor.
abstract: OBJECTIVE
  To determine the utility of elastosonography (ES) combined to cervical length measurement to predict preterm labor.
  
  
  METHODS
  One hundred twenty-seven women with pregnancies between 21 to 36 weeks of gestation without any risk factor for preterm labor were included in the study. All subjects underwent sonographic evaluation including fetal biometry, cervical length measurement and ES of uterine myometrium. Subcutaneous tissue was the reference point for ES evaluation. Tissue strain ratio values were obtained from all patients.
  
  
  RESULTS
  Cervical length was a significant predictor for preterm delivery (AUC = 0.958, p < 0.001). Optimal cut-off value was obtained at 30 mm with 92% sensitivity and 81% specificity. Elastosonographic strain ratio was also a significant predictor for preterm delivery (AUC = 0.827, p < 0.001). Optimal cut-off value was obtained at 4.7 with 79% sensitivity and 91% specificity. In linear regression analysis, strain ratio (R(2 )= 0.61, beta = 0.171, p = 0.03) and cervical length (R(2 )= 0.61, beta = -0.516, p < 0.001) were significantly associated with preterm delivery. Cervical length < 30 mm [39.1 (95 CI, 6.6-231.5, p < 0.001)] and strain ratio > 4.7 [24.5 (95 CI, 4.1-146.5, p < 0.001)] were the risk factors for preterm delivery.
  
  
  CONCLUSIONS
  Elastosonographic evaluation of uterine myometrium was found to be significantly correlated with cervical length but cervical length measurement is a better predictor for preterm labor than ES.
authors.affiliation: Department of Obstetrics and Gynecology, Dr. Sami Ulus Maternity and Womens' Health Training and Research Hospital , Ankara , Turkey .
authors.forename: Enis
authors.initials: E
authors.lastname: Ozkaya
authors.forename: Alptekin
authors.initials: A
authors.lastname: Tosun
authors.forename: Vakkas
authors.initials: V
authors.lastname: Korkmaz
authors.forename: Emine
authors.initials: E
authors.lastname: Kucuk
authors.forename: Demet
authors.initials: D
authors.lastname: Sengul
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kucukozkan
mesh_terms: D000328:Adult; D054791:Cervical Length Measurement; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D009215:Myometrium / Q000000981:diagnostic imaging* / Q000502:physiology; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging*; D011247:Pregnancy; D050507:Subcutaneous Fat, Abdominal / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Cervical length; elastosonography; preterm labor