title: Cervical sonoelastography for improving prediction of preterm birth compared with cervical length measurement and fetal fibronectin test.
abstract: OBJECTIVE
  Accurate prediction of the risk of spontaneous preterm birth is crucial for the clinical management of patients with preterm labor. The aim of the study was to investigate whether cervical sonoelastography improves prediction of spontaneous preterm birth compared with cervical length measurement and a fetal fibronectin (fFN) test.
  
  
  METHODS
  A prospective cohort study was conducted including 64 patients with preterm labor at 23-34 weeks of gestation. Patients had an fFN test and transvaginal cervical length measurement, followed by real-time cervical sonoelastography. The ratio of nondeformable tissue to the total area of a designed region of interest was analyzed and related to the gestational week of delivery.
  
  
  RESULTS
  Cervical sonoelastography and fFN test show a significant correlation with spontaneous preterm delivery (P=0.007, P=0.001), resulting in 72.7%/36% sensitivity and 73%/95% specificity. The positive predictive value (PPV) was 61.5%/81.8% and the negative predictive value was 81.8%/70%. The cervical length was not different in cases with and without term delivery (P=0.165).
  
  
  CONCLUSIONS
  Cervical sonoelastography is a promising technique that can complement routine diagnostic procedures to improve prediction of preterm birth. The PPV is improved by an fFN test.
authors.forename: Dinah
authors.initials: D
authors.lastname: von Schöning
authors.forename: Thomas
authors.initials: T
authors.lastname: Fischer
authors.forename: Elisabeth
authors.initials: E
authors.lastname: von Tucher
authors.forename: Torsten
authors.initials: T
authors.lastname: Slowinski
authors.forename: Alexander
authors.initials: A
authors.lastname: Weichert
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Henrich
authors.forename: Anke
authors.initials: A
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D004311:Double-Blind Method; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005353:Fibronectins / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: C403421:FFN protein, human; D005353:Fibronectins