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Using shear wave elastography to assess uterine tonicity after vaginal delivery
- Source :
- Scientific Reports, Vol 11, Iss 1, Pp 1-8 (2021), Scientific reports, vol. 11, no. 1, pp. 10420, Scientific Reports
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- This study aims to evaluate the feasibility and clinical interest of shear wave elastography, by quantitatively estimating the baseline stiffness of the myometrium before and after placental expulsion. We conducted a prospective cohort study of women at term, without known risk factors for postpartum hemorrhage, who gave birth via spontaneous labor in our tertiary center. Myometrium tonicity was evaluated based on measurements of shear wave speed (SWS) in the anterior uterine corpus. All data points were collected by a single operator. Measurements were carried out at three different time points: after fetal delivery (T1), after placental delivery (T2) and 30 min after placental delivery (T3). Our primary objective was to assess the feasibility of this new imaging technique. Ten valid SWS measurements obtained at each of the three different time points were considered as a positive primary outcome. Our secondary objectives were to evaluate the difference in median myometrial shear wave velocity between each time point, as well as to determine the correlation between myometrial shear wave velocity and patients’ characteristics. 38 women were recruited during the study period, of whom 34 met the study criteria. 1017 SWS measurements were obtained. The median time to perform measurements was 16 s for one value, and 2 min 56 s for ten. For 11 women (32%) it was not possible to achieve ten SWS at T1 as placental expulsion immediately followed the birth of the newborn. One patient experienced placental retention and only measurements at T1 were performed. For all other patients, we were successfully able to obtain all measures as intended. There was no difference in the mean shear wave speed between the three time points. After adjustments for confounders, we observed a significant correlation for total blood loss (correlation coefficient = − 0.26, p p = 0.03), and newborn weight (correlation coefficient = − 0.08, p = 0.001). It is feasible to assess uterine tonicity by shear wave imaging, after placental expulsion. We did not observe a variance in uterine tonicity between the three time points. Women who had higher blood loss, received more units of oxytocin and/or those with newborns of a higher weight exhibited lower shear wave speed measures.
- Subjects :
- Adult
Reproductive signs and symptoms
medicine.medical_specialty
Placental expulsion
Science
Placental Retention
Oxytocin
Risk Assessment
Article
030218 nuclear medicine & medical imaging
Uterine Contraction
Uterine Monitoring
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Birth Weight
Humans
Prospective Studies
Time point
Prospective cohort study
Fetus
030219 obstetrics & reproductive medicine
Multidisciplinary
business.industry
Vaginal delivery
Postpartum Hemorrhage
Infant, Newborn
Myometrium
Delivery, Obstetric
Cardiology
Elasticity Imaging Techniques
Feasibility Studies
Medicine
Tonicity
Female
Medical imaging
business
Subjects
Details
- ISSN :
- 20452322
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Scientific Reports
- Accession number :
- edsair.doi.dedup.....f1e9a6a87eb1c0b778477c58f56dde6a