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Aim: The aim of this study was to compare shear wave cervical elasticity between term and preterm delivery group. Methods: A prospective cohort study was conducted in enrolled 158 pregnant women at 18–24 weeks of gestation who come for second trimester scan consecutively. Transvaginal ultrasonography for cervical length as well as cervical elasticity in five regions of interest was performed. Intraobserver and interobserver reproducibility were evaluated. Gestational age at deliveries was followed, and cervical shear wave elasticity between term and preterm group was compared. Results: A total of 158 pregnant women were enrolled in this study while 120 pregnancies data were collected for subsequent analysis, 10 pregnancies spontaneously delivered during the preterm period and 110 pregnancies delivered at term. Intraobserver and interobserver reproducibility were high; however, cervical shear wave elasticity in both groups were not significantly different (external anterior lip 2.29 ± 0.66 and 2.45 ± 0.58 m/s, P value 0.30, internal anterior lip 2.74 ± 0.96 and 2.80 ± 0.61 m/s, P value 0.83). Nonsignificant correlations of cervical shear wave elasticity with gestational age and cervical length (r = −0.1 and r = 0.02, respectively) were demonstrated. Conclusion: Cervical shear wave elasticity in preterm and term groups was not significantly different when measured at 18–24 weeks of gestation. There are nonsignificant correlations between cervical shear wave elasticity, gestational age and cervical length. Cervical shear wave elastography alone should not be used as a predictor for preterm delivery. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effect of depth on cervical shear-wave elastography. Methods: Shear-wave elastography was applied to estimate the velocity of propagation of the acoustic force impulse (shear wave) in the cervix of 154 pregnant women at 11-36 weeks of gestation. Shear-wave speed (SWS) was evaluated in cross-sectional views of the internal and external cervical os in five regions of interest: anterior, posterior, lateral right, lateral left, and endocervix. Distance from the center of the ultrasound (US) transducer to the center of each region of interest was registered. Results: In all regions, SWS decreased significantly with gestational age (P=0.006). In the internal os, SWS was similar among the anterior, posterior, and lateral regions and lower in the endocervix. In the external os, the endocervix and anterior regions showed similar SWS values, lower than those from the posterior and lateral regions. In the endocervix, these differences remained significant after adjustment for depth, gestational age, and cervical length. SWS estimations in all regions of the internal os were higher than those of the external os, suggesting denser tissue. Conclusion: Depth from the US probe to different regions in the cervix did not significantly affect the SWS estimations. [ABSTRACT FROM AUTHOR]

Objective: To determine if there is an association between cervical strain, evaluated using ultrasound elastography, and spontaneous preterm delivery (sPTD) <37 weeks of gestation. Methods: One hundred and eighty nine (189) women at 16-24 weeks of gestation were evaluated. Ultrasound elastography was used to estimate cervical strain in three anatomical planes: one mid-sagittal in the same plane used for cervical length measurement, and two cross sectional images: one at the level of the internal cervical os, and the other at the level of the external cervical os. In each plane, two regions of interest (endocervix and entire cervix) were examined; a total of six regions of interest were evaluated. Results: The prevalence of sPTD was 11% (21/189). Strain values from each of the six cervical regions correlated weakly with cervical length (from r=-0.24, P<0.001 to r=-0.03, P=0.69). Strain measurements obtained in a cross sectional view of the internal cervical os were significantly associated with sPTD. Women with strain values ≤25th centile in the endocervical canal (0.19) and in the entire cervix (0.14) were 80% less likely to have a sPTD than women with strain values >25th centile [endocervical: odds ratio (OR) 0.2; 95% confidence interval (CI), 0.03-0.96; entire cervix: OR 0.17; 95% CI, 0.03-0.9]. Additional adjustment for gestational age, race, smoking status, parity, maternal age, pre-pregnancy body mass index, and previous preterm delivery did not appreciably alter the magnitude or statistical significance of these associations. Strain values obtained from the external cervical os and from the sagittal view were not associated with sPTD. Conclusion: Low strain values in the internal cervical os were associated with a significantly lower risk of spontaneous preterm delivery <37 weeks of gestation. [ABSTRACT FROM AUTHOR]