Evaluating postpartum cervical remodeling with quantitative ultrasound technology

Abstract

Having a history of a previous spontaneous preterm birth (sPTB) is the strongest risk factor for recurrent sPTB. It is unknown if there are differences in postpartum cervical remodeling between women who have delivered spontaneous preterm (sPT) and full-term. No studies have evaluated the role of postpartum remodeling between the two groups. Quantitative ultrasound (QUS) is a noninvasive ultrasound technology used to quantify tissue microstructure and function. QUS biomarkers were used to evaluate postpartum cervical microstructure in women who delivered sPT and full-term. Data were collected from 54 women:14 who delivered sPT and 40 who delivered full-term. Transvaginal QUS scans were performed at 6 weeks (±2 weeks) after delivery. Attenuation coefficient (AC), backscatter coefficient (BSC), and shear wave speed (SWS) QUS biomarkers were collected. BSC was significantly higher at six weeks postpartum in women who delivered sPT versus full-term (p = 0.01), while the AC approached statistical significance (p = 0.09). QUS biomarker BSC was able to identify cervical microstructure differences at six weeks postpartum between women who delivered sPT and full-term. QUS technology may improve our understanding of postpartum cervical remodeling and has the potential to noninvasively direct precision-health approaches for recurrent sPTB. [Work supported by NIH 5F31NR019716.]