title: Assessment of cervical elastography strain pattern and its association with preterm birth.
abstract: OBJECTIVE
  The aim of the study was to assess the cervical strain pattern by an ultrasound elastography cervix examination and to determine its association with preterm delivery.
  
  
  METHODS
  In this study, 30 cases resulting in preterm birth and 30 gestational age-matched controls were included. A vaginal ultrasound examination with cervical length and elastography measurement was performed. We calculated four strain ratios (SR1-SR4) of the regions of interest (ROIs) arranged in pairs in four different positions on the anterior cervical lip. The strain ratios were correlated to the outcome of spontaneous preterm delivery. The inter-observer and intra-observer variability of the strain measurement was evaluated.
  
  
  RESULTS
  We observed an association between the value of the strain ratio that was calculated from the ROIs placed side by side in the middle of the anterior lip (SR4), and preterm delivery (P<0.001). The predictive values of cervical length and SR4 were comparable (AUC 0.7394; AUC 0.8322, respectively). The combination of cervical length and SR4 was superior in predicting preterm delivery compared to both parameters alone (AUC 0.8789). The inter-observer and intra-observer variability of data acquisition and measurement was excellent.
  
  
  CONCLUSIONS
  Our study assesses the cervical elastography strain pattern and shows a correlation to a spontaneous preterm birth.
authors.affiliation: .
authors.forename: Vera
authors.initials: V
authors.lastname: Oturina
authors.affiliation: .
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hammer
authors.affiliation: .
authors.forename: Mareike
authors.initials: M
authors.lastname: Möllers
authors.affiliation: .
authors.forename: Janina
authors.initials: J
authors.lastname: Braun
authors.affiliation: .
authors.forename: Maria Karina
authors.initials: MK
authors.lastname: Falkenberg
authors.affiliation: .
authors.forename: Kathrin Oelmeier
authors.initials: KO
authors.lastname: de Murcia
authors.affiliation: .
authors.forename: Ute
authors.initials: U
authors.lastname: Möllmann
authors.affiliation: .
authors.forename: Maria
authors.initials: M
authors.lastname: Eveslage
authors.affiliation: .
authors.forename: Arrigo
authors.initials: A
authors.lastname: Fruscalzo
authors.affiliation: .
authors.forename: Walter
authors.initials: W
authors.lastname: Klockenbusch
authors.affiliation: .
authors.forename: Ralf
authors.initials: R
authors.lastname: Schmitz
mesh_terms: D016022:Case-Control Studies; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000000981:diagnostic imaging*
keywords: Cervix; pregnancy; prenatal diagnosis; preterm birth; ultrasound