title: Is evaluation of placenta with real-time sonoelastography during the second trimester of pregnancy an effective method for the assessment of spontaneous preterm birth risk?
abstract: OBJECTIVE
  The aim of this study is to investigate the effectiveness of placental strain ratio (SR) values measured by real-time sonoelastography (SE) in the second trimester in the prediction of spontaneous preterm birth (sPTB).
  
  
  METHODS
  This study included 70 pregnant women who applied to our clinic for routine second-trimester screening. Placental SR measurements were performed with the SE method. Two different SR measurements were performed by taking two different tissues as references. The SR value measured when taking the rectus abdominis muscle as a reference was termed the muscle-to-placenta strain ratio (MPSR), while the SR value measured when taking subcutaneous tissue as a reference was termed the fat-to-placenta strain ratio (FPSR). Women whose gestational age at birth was less than 37 weeks 0 days were accepted as sPTB. The association between gestational age at birth and MPSR and FPSR was investigated. Receiver operating characteristics analysis was used to calculate the sensitivity and specificity of the elastographic outcomes.
  
  
  RESULTS
  There was a low-level negative correlation between MPSR and gestational age at birth (r=-0.300, P=.012) and there was a moderate-level negative correlation between FPSR and gestational age at birth (r=-0.513, P<.001). The multivariate linear regression analysis showed that the FPSR (β=0.609, P=.002) was the significant predictor for the sPTB.
  
  
  CONCLUSIONS
  Our data indicate that the FPSR value measured with real-time SE in the second trimester of pregnancy may be effective in the prediction of sPTB.
authors.affiliation: Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey. Electronic address: edalbayrak1@hotmail.com.
authors.forename: Eda
authors.initials: E
authors.lastname: Albayrak
authors.affiliation: Department of Obstetrics and Gynecology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey. Electronic address: hatice_yilmaz47@hotmail.com.
authors.forename: Hatice Yılmaz
authors.initials: HY
authors.lastname: Dogru
authors.affiliation: Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey. Electronic address: doktor.zafer@mynet.com.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Ozmen
authors.affiliation: Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey. Electronic address: aaltunkas@hotmail.com.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Altunkas
authors.affiliation: Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey. Electronic address: doktorozlemtugce@gmail.com.
authors.forename: Tugce Ozlem
authors.initials: TO
authors.lastname: Kalayci
authors.affiliation: Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey. Electronic address: drfatihinci@gmail.com.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Inci
authors.affiliation: Department of Radiology, Istanbul Bilim University, Medical Faculty, Şişli Florance Nightingale Hospital, Istanbul, Turkey. Electronic address: servergreen@gmail.com.
authors.forename: Sadık
authors.initials: S
authors.lastname: Server
authors.affiliation: Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey. Electronic address: fitnats@gmail.com.
authors.forename: Fitnet
authors.initials: F
authors.lastname: Sonmezgoz
authors.affiliation: Department of Radiology, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey. Electronic address: fatmakokcu79@hotmail.com.
authors.forename: Fatma
authors.initials: F
authors.lastname: Aktas
authors.affiliation: Department of Biostatistics, Gaziosmanpasa University, Medical Faculty, Tokat, Turkey. Electronic address: mosmandemir@hotmail.com.
authors.forename: Osman
authors.initials: O
authors.lastname: Demir
mesh_terms: D000328:Adult; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D010920:Placenta / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000175:diagnosis* / Q000453:epidemiology; D018570:Risk Assessment; D014421:Turkey / Q000453:epidemiology; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: Placenta; Preterm birth; Sonoelastography; Strain