Objective: To evaluate the prediction performance of E-Cervix™ for preterm birth in twin pregnancies with threatened preterm labor.
Methods: This was a single-center retrospective cohort study of twin pregnancies presenting to obstetrics triage for threatened preterm labor (PTL) between 23 0/7 - 33 6/7 weeks who received screening for PTL with transvaginal ultrasound cervical length (TVU CL) and cervical elastography with E-Cervix™ at the time of triage. Cervical elastography parameters were examined and compared between women who delivered preterm and those who did not. The quantification of cervical strain was calculated by a data analysis system that directly analyzes raw data from the region of interest (ROI) and described as hardness ratio (HR), mean strain level within 1 cm from internal (IOS) and external (EOS) os.
Results: 63 twin gestations without prior preterm birth and with threatened PTL between 23 0/7 - 33 6/7 weeks of gestation were included in the study. 27 (42.9 %) had cervical length < 25 mm, and were admitted for true PLT. Out of the 36 women with cervical length ≥ 25 mm, 6 (16.7 %) were admitted. Women with threatened PTL had significantly higher HR compared to those with true PTL (p < 0.01), and significantly lower IOS and EOS. Women who delivered preterm had significantly higher HR compared to those who did not delivery preterm and significantly lower IOS and EOS, in overall cohort, and in the subset of women with true PTL. Incidences of HR < 50 % and < 35 % were statistically significantly higher in women who delivered preterm compared to those who did not (p < 0.01).
Conclusion: Cervical elastography with E-Cervix™ may be useful for assessment of twin gestations presenting to obstetrics triage for threatened PTL.
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| http://dx.doi.org/10.1016/j.ejogrb.2024.05.001 | DOI Listing |
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Article Synopsis
- Preterm delivery significantly contributes to neonatal deaths and long-term health issues, presenting a major global health challenge, with cervical elastography emerging as a promising diagnostic tool for predicting such deliveries.
- The study assessed the effectiveness of transvaginal strain cervical elastography in predicting preterm delivery among 75 low-risk, asymptomatic women, utilizing ultrasound to analyze cervical length and strain data.
- Findings revealed that a red color sign at the anterior lip of the cervix was a strong predictor of preterm delivery, alongside additional indicators like an elastography strain ratio greater than 2 and a cervical length of 2.8 cm or less.
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