Cervical sonoelastography for improving prediction of preterm birth compared with cervical length measurement and fetal fibronectin test

Schöning, D. von; Fischer, Thomas; Tucher, E von; Slowinski, Torsten; Weichert, Alexander; Henrich, Wolfgang; Thomas, Anke

doi:10.1515/jpm-2014-0356

Cited by 20 publications

(12 citation statements)

References 6 publications

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“…Nowadays, sonoelastography is used to visualize tissue stiffness and elasticity by superimposing a colorcoded image, which is similar to color Doppler imaging. Cervical sonoelastography has been widely employed to evaluate cervical lesions [15] and preterm birth [18], or prior to the induction of labor [16]. However, while some authors have reported advantageous findings [33], others have found contradictory results [34].…”

Section: Discussion ▼mentioning

confidence: 99%

“…Therefore, we chose to measure the tissue stiffness in the anterior cervical lip and internal os. Our method was described in previous studies of our group [15,18]. We investigated a moment not a time interval.…”

Section: Discussion ▼mentioning

confidence: 99%

“…However, both of the aforementioned studies are rather limited, as the analyzed data stemmed from selected areas of the whole elastographic image. Given that penetration depth is a physical limitation of sonoelastography, we evaluated the anterior lip of the cervix as described in previous studies [15,18]. From our point of view, sonoelastography is pioneering technology and valuable tool because the results are immediately available.…”

Section: Introduction ▼mentioning

confidence: 99%

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Cervical Sonoelastography and Cervical Length Measurement but not Cervicovaginal Interleukin-6 Are Predictors for Preterm Birth

Weichert

Schöning

Fischer

et al. 2016

Ultrasound International Open

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reproductive technologies and better outcomes in indicated preterm births [5]. The ability to identify women at high risk for spontaneous preterm birth is crucial yet remains difficult. In women with preterm contractions, 30 % of preterm labors resolve spontaneously, whereas 50 % of women treated for preterm labor deliver at term [6]. In addition to typical risk factors, such as low socioeconomic status, multiple pregnancies, or a history of cervical surgery, the primary methods used for the detection of preterm birth are transvaginal ultrasound and the presence of fetal fibronectin (fFN) in cervicovaginal fluid. These methods allow clinicians to perform targeted interventions such as referral to a tertiary care center, antenatal corticosteroid administration, and tocolysis. The relationship between cervical length and the incidence of preterm birth is well-known [7]. Introduction ▼Preterm birth is defined as delivery before a gestational age of 37 weeks. Annually, more than 15 million children are affected worldwide. It is the main cause of perinatal morbidity and mortality, and almost one-half of long-term neurologic morbidity cases and approximately 3-quarters of neonatal mortality are associated with preterm birth [1,2]. Furthermore, approximately one-third of neonatal deaths are caused by prematurity leading to more than 1 million newborn deaths per year [3]. Despite advancing knowledge of the risk factors and mechanisms associated with preterm labor and delivery, the preterm birth rate has risen in most industrialized countries [4]. This increase has been partially attributed to a rise in multiple pregnancies that occurred as a result of assisted Purpose: Worldwide, preterm birth annually affects more than 15 million infants. Despite increasing knowledge of the risk factors and mechanisms associated with preterm labor, the preterm birth rate has risen in most industrialized countries. The ability to identify women at high risk for spontaneous preterm birth is crucial yet remains difficult. The aim of the present study was to assess the value of cervical length measurements in combination with sonoelastography and interleukin 6 (IL-6) concentrations in cervicovaginal secretions to identify women at risk for preterm birth. Materials and Methods: 36 pregnant women with signs of threatened preterm birth were enrolled in our prospective cohort study. Cervical length measurement, sonoelastography, and IL-6 levels from cervicovaginal swab samples were measured. Results:The preterm birth rate was found to be 33.3 % in our study cohort. Maternal age did not differ between the preterm and term birth groups. Measurement of the cervical length alone was found to have a sensitivity of 0.7 and a specificity of 0.8, whereas cervical sonoelastography had a sensitivity of 0.66 and a specificity of 0.82. By using a combination of both methods, the sensitivity and specificity were found to be 0.9 and 0.7, respectively. IL-6 levels were not found to differ between women with term deliveries and women with preterm births. Conc...

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Section: Discussion ▼mentioning

confidence: 99%

Section: Discussion ▼mentioning

confidence: 99%

Section: Introduction ▼mentioning

confidence: 99%

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Cervical Sonoelastography and Cervical Length Measurement but not Cervicovaginal Interleukin-6 Are Predictors for Preterm Birth

Weichert

Schöning

Fischer

et al. 2016

Ultrasound International Open

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“…Measurements including cervical length via transvaginal ultrasonography, evaluation of the cervical tissue stiffness by sonoelastography and mean gray analysis were performed using quantitative ultrasound. The methods of detection and evaluation were determined by previous protocols 22 , 24 , 28 . Cervical length was defined as the distance between the internal and external os, which was measured in a sagittal plane of the cervix.…”

Section: Methodsmentioning

confidence: 99%

New model for predicting preterm delivery during the second trimester of pregnancy

Zhu

Peng

Tian

et al. 2017

Sci Rep

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In this study, a new model for predicting preterm delivery (PD) was proposed. The primary model was constructed using ten selected variables, as previously defined in seventeen different studies. The ability of the model to predict PD was evaluated using the combined measurement from these variables. Therefore, a prospective investigation was performed by enrolling 130 pregnant patients whose gestational ages varied from 17+0 to 28+6 weeks. The patients underwent epidemiological surveys and ultrasonographic measurements of their cervixes, and cervicovaginal fluid and serum were collected during a routine speculum examination performed by the managing gynecologist. The results showed eight significant variables were included in the present analysis, and combination of the positive variables indicated an increased probability of PD in pregnant patients. The accuracy for predicting PD were as follows: one positive – 42.9%; two positives – 75.0%; three positives – 81.8% and four positives – 100.0%. In particular, the combination of ≥2× positives had the best predictive value, with a relatively high sensitivity (82.6%), specificity (88.1%) and accuracy rate (79.2%), and was considered the cut-off point for predicting PD. In conclusion, the new model provides a useful reference for evaluating the risk of PD in clinical cases.

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“…In the same issue, von Schöning and colleagues conducted a small prospective cohort study among 64 patients with preterm labor at 23-34 weeks to determine whether cervical sonoelastography improved prediction of PTB compared with CL measurement and fFN [14]. The former is a measure of cervical elasticity and consists of the ratio of nondeformable cervical tissue to the total region of interest.…”

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confidence: 99%

Risk factors for preterm birth and new approaches to its early diagnosis

Lockwood

2015

Journal of Perinatal Medicine

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Cervical sonoelastography for improving prediction of preterm birth compared with cervical length measurement and fetal fibronectin test

Abstract: Cervical sonoelastography is a promising technique that can complement routine diagnostic procedures to improve prediction of preterm birth. The PPV is improved by an fFN test.

Cited by 20 publications

References 6 publications

Cervical Sonoelastography and Cervical Length Measurement but not Cervicovaginal Interleukin-6 Are Predictors for Preterm Birth

Cervical Sonoelastography and Cervical Length Measurement but not Cervicovaginal Interleukin-6 Are Predictors for Preterm Birth

New model for predicting preterm delivery during the second trimester of pregnancy

Risk factors for preterm birth and new approaches to its early diagnosis

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