The Feasibility of Cervical Elastography in Predicting Preterm Delivery in Singleton Pregnancy with Short Cervix Following Progesterone Treatment.

Hyun Soo Park,Ja-Young Kwon,Han Sung Hwang,Yun Ji Jung,Jeongeun Shin,Yejin Park,Hyun Mi Kim,Soo-young Oh,Seok-Jae Heo,Won Joon Seong,Hayan Kwon,Ji-Hee Sung,Hyun-Joo Seol,Inkyung Jung

doi:10.3390/ijerph18042026

Abstract

Previous studies demonstrated an association between cervical strain and risk of spontaneous preterm delivery (sPTD). The present study aimed to assess the efficacy of elastography in predicting sPTD at <32 weeks of gestation in women with singleton pregnancies receiving progesterone for short cervix (≤2.5 cm) diagnosed between 16 and 28 weeks of gestation Among 115 participants eligible for analysis, nine had sPTD at <32 weeks. Preprogesterone (PP0) mean internal os strain (IOS), elasticity contrast index (ECI), hardness ratio (HR), one-week postprogesterone (PP1) IOS, mean external os strain (EOS), ECI, and HR were significantly different between groups. Higher PP0 IOS, PP1 IOS, and PP1 EOS were associated with a 2.92, 4.39 and 3.65-fold increase in the risk of sPTD at <32 weeks, respectively (adjusted for cervical length (CL) at diagnosis; p = 0.04, 0.012 and 0.026, respectively). A combination of CL at diagnosis, PP0 IOS and PP1 EOS showed a significantly higher area under the receiver operating characteristic curve (0.858) than that of CL alone (p = 0.041). In women with singleton pregnancies receiving progesterone for short cervix, cervical elastography performed before and one week after progesterone treatment may be useful in predicting sPTD at <32 weeks of gestation.

Highlights

IntroductionThe efficacy of progesterone treatment in women with short cervix (≤2.5 cm) at the mid-trimester for preventing preterm birth has been widely studied, and study results have creativecommons.org/licenses/by/
To investigate the possible role of cervical elastography in determining the treatment success of progesterone in pregnant women with short cervix, the present study aimed to assess the efficacy in predicting spontaneous preterm delivery (sPTD) at
‘Predictionof ofpreterm pretermdelivery deliveryand andestablishing establishingmechanisms mechanismsof ofpreterm pretermdelivery delivery prevention high-risk pregnancies pregnanciesofofpreterm preterm delivery using cervical elastography’, a prevention in high-risk delivery using cervical elastography’, a total total of pregnant women were diagnosed with short cervix at to weeks of gestaof 190 pregnant women were diagnosed with short cervix at 16 to 28 weeks of gestation and tion and prescribed progesterone for the prevention

Summary

Introduction

The efficacy of progesterone treatment in women with short cervix (≤2.5 cm) at the mid-trimester for preventing preterm birth has been widely studied, and study results have creativecommons.org/licenses/by/. Most studies on cervical elastography have evaluated the association between having a short cervix, regardless of receiving progesterone, and preterm birth [9,10,18]. These studies demonstrated that in pregnant women with short CL, the PPV for predicting preterm birth can be enhanced by adding a cervical strain value rather than using CL alone. To investigate the possible role of cervical elastography in determining the treatment success of progesterone in pregnant women with short cervix, the present study aimed to assess the efficacy in predicting sPTD at

Study Population

Cervical Length and Elastography Measurement

Results

Pre and Postprogesterone Elastographic Parameters

Receiver

Discussion

Conclusions