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

Yun Ji Jung, Hayan Kwon, Jeongeun Shin, Yejin Park, Seok-Jae Heo, Hyun Soo Park, Soo-young Oh, Ji-Hee Sung, Hyun-Joo Seol, Hyun Mi Kim, Won Joon Seong, Han Sung Hwang, Inkyung Jung and Ja-Young Kwon
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Yun Ji Jung: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Korea
Hayan Kwon: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Korea
Jeongeun Shin: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Korea
Yejin Park: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Korea
Seok-Jae Heo: Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul 03722, Korea
Hyun Soo Park: Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Dongguk University, Goyang 10326, Korea
Soo-young Oh: Samsung Medical Center, Department of Obstetrics and Gynecology, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea
Ji-Hee Sung: Samsung Medical Center, Department of Obstetrics and Gynecology, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea
Hyun-Joo Seol: Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul 05278, Korea
Hyun Mi Kim: Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Hospital, Daegu 41404, Korea
Won Joon Seong: Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Hospital, Daegu 41404, Korea
Han Sung Hwang: Department of Obstetrics and Gynecology, School of Medical, Konkuk University, Seoul 05030, Korea
Inkyung Jung: Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul 03722, Korea
Ja-Young Kwon: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Korea

IJERPH, 2021, vol. 18, issue 4, 1-12

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.

Keywords: short cervix; elastography; progesterone; prediction; preterm delivery (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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