title: Transient Elastography to Assess the Cervical Ripening during Pregnancy: A Preliminary Study.
abstract: PurposeTo explore the feasibility of transient elastography (TE) to quantify cervical stiffness changes during normal pregnancy and its spatial variability.Materials and MethodsTE was used to quantify the cervical stiffness in four anatomical regions. 42 women between 17 and 43 years of age and at 6 - 41 weeks of gestation were studied. The stiffness was related to gestational age at the time of examination, interval from ultrasound examination to delivery and cervical length to evaluate the potential of TE to assess cervical ripening. In addition, a sensitivity analysis based on Cronbach's alpha coefficient was carried out to assess the concordance between inter/intra-operator measurements.ResultsThere were significant correlations between cervical stiffness measured in the four regions with gestational age and the remaining time for delivery. Results confirm stiffness variability within the cervix. No significant association was found between cervical length and stiffness in the four ROIs. Associations between gestational age and remaining time for delivery with cervical length present weaker correlations than with cervical stiffness. The external part of the cervix was significantly softer than the internal one, and these stiffness values vary significantly in the anterior compared to the posterior cervix. The measurements taken by the same and by two different observers for different regions in the cervix were reliable and reproducible.ConclusionIt is feasible to objectively quantify the decrease of cervical stiffness correlated to gestational age. Transient elastography is a valuable promising tool to provide additional information on the process of cervical effacement to that obtained from digital examination and conventional ultrasound. Further studies are needed to assess the feasibility of the technique in obstetric clinical applications, such as prediction of preterm birth or success in labor induction.
authors.affiliation: Department of Structural Mechanics, University of Granada, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Peralta
authors.affiliation: Obstetrics and Gynecology, Maternal-Fetal Medicine Unit, San Cecilio University Hospital, HUSC, Granada, Spain.
authors.forename: Francisca Sonia
authors.initials: FS
authors.lastname: Molina
authors.affiliation: Department of Structural Mechanics, University of Granada, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Melchor
authors.affiliation: Obstetrics and Gynecology, Maternal-Fetal Medicine Unit, San Cecilio University Hospital, HUSC, Granada, Spain.
authors.forename: Luisa Fernanda
authors.initials: LF
authors.lastname: Gómez
authors.affiliation: Department of Obstetrics and Gynecology, University of Granada, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Massó
authors.affiliation: Department of Obstetrics and Gynecology, University of Granada, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Florido
authors.affiliation: Department of Structural Mechanics, University of Granada, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Rus
mesh_terms: D000293:Adolescent; D000328:Adult; D020070:Cervical Ripening; D002584:Cervix Uteri / Q000000981:diagnostic imaging; D054459:Elasticity Imaging Techniques; D005260:Female; D005865:Gestational Age; D006801:Humans; D007751:Labor, Induced; D011247:Pregnancy; D047928:Premature Birth; D055815:Young Adult