Value of cervical strain in ultrasound elastography as a predictor of spontaneous preterm delivery

Abstract

BackgroundCervical incompetence is a failure of the cervix to retain the products of conception throughout pregnancy, which results into cervical dilatation and preterm delivery. Many methods are conducted for early detection of cervical shortening, ripening and eventually dilatation to lessen the incidence of the preterm delivery, which is responsible for about 75% of neonatal comorbidities. Ultrasound plays an important role in the diagnosis and early detection of cervical incompetence. Elastography is a relatively new technique, which investigates into another important factor for cervical insufficiency which is “tissue stiffness”. The process of early cervical ripening, which is an important and main step in spontaneous preterm delivery, precedes cervical shortening and renders the human cervix soft which can be diagnosed through the color-coding method of the sonoelastography technique. The aim of this study is to determine the value of cervical elastography as a predictor of spontaneous preterm labor and validate the role of strain ratio in such technique.ResultsIn our study, we examined the pregnant females by transvaginal conventional B-mode ultrasound and complementary elastography technique and recorded the elastography index of their cervix, internal os and external os together with measuring the amount of strain and strain ratio at internal and external os.ConclusionsWe concluded that women who had preterm delivery did have higher strain and elastography index as their cervices were softer than those who had full-term deliveries. Elastography therefore can be a reliable method for the prediction of preterm delivery.