Abstract
A torsional wave (TW) sensor prototype was employed to quantify stiffness of the cervix in pregnant women. A cross-sectional study in a total of 18 women between 16 weeks and 35 weeks + 5 days of gestation was performed. The potential of TW technique to assess cervical ripening was evaluated by the measurement of stiffness related to gestational age and cervical length. Statistically significant correlations were found between cervical stiffness and gestational age (, , using 1 kHz waves and , , using 1.5 kHz waves). A uniform decrease in stiffness of the cervical tissue was confirmed to happen during the complete gestation. There was no significant correlation between stiffness and cervical length. A stronger association between gestational age and cervical stiffness was found compared to gestational age and cervical length correlation. As a conclusion, TW technique is a feasible approach to objectively quantify the decrease of cervical stiffness related to gestational age. Further research is required to evaluate the application of TW technique in obstetric evaluations, such as prediction of preterm delivery and labor induction failure.
Highlights
IntroductionComplications of preterm birth are the main cause of child mortality under five years of age [1,3]
15 million babies are born preterm per year, i.e., more than 1 in 10 newborns, and this number is rising in both developing countries and Europe [1,2].Worldwide, complications of preterm birth are the main cause of child mortality under five years of age [1,3]
Current models based on cervical length, obstetric history, digital vaginal examination and echography of the cervix are not able to accurately predict a preterm birth with sufficient anticipation, and there is a lack of evidence on how to prevent preterm delivery [4,5]
Summary
Complications of preterm birth are the main cause of child mortality under five years of age [1,3]. Clinical and social risk factors of preterm birth have been identified to develop feasible and cost-effective care measures to save children [1]. A high proportion of spontaneous preterm birth remains unpredictable. Current models based on cervical length, obstetric history, digital vaginal examination and echography of the cervix are not able to accurately predict a preterm birth with sufficient anticipation, and there is a lack of evidence on how to prevent preterm delivery [4,5]. The current lack of a clinical tool for the quantitative evaluation of the biomechanic parameters of the cervix is probably a barrier to advance in preventing spontaneous preterm birth [6]. Since 2012, the WHO is encouraging to Sensors 2019, 19, 3249; doi:10.3390/s19153249 www.mdpi.com/journal/sensors
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