Relationship between cervical elastography and spontaneous onset of labor

Yo, Yoshie; Kotani, Yoshihisa; Shiro, Reona; Yamamoto, Keizô; Fujishima, Risa; Takaya, Hisamitsu; Suzuki, Ayako; Shimaoka, Masao; Matsumura, Noriomi

doi:10.1038/s41598-020-76753-4

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…In addition, studies have reported that cervical elastography performed during pregnancy shows cervical softening and maturation (especially in the internal cervical os) [15,16]. Yo et al performed weekly cervical elastography by starting at the 36th week on 238 pregnant women and found cervical elastography at the 39th gestational week to be useful to evaluate the time of delivery [17]. Lu et al reported that shear wave elastography had a higher estimation accuracy than BS-based models as a result of labor induction [18].…”

Section: Discussionmentioning

confidence: 99%

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Halilzade

HALİLZADE

Sert

et al. 2023

Z Geburtshilfe Neonatol

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ObjectiveWe aimed to show whether elastography can be analternative, although the Bishop score used in the follow-up of labor induction success with oxytocin is a relative concept. Material and methods This prospective case-control study includes 56 cases admitted to a tertiary maternity hospital for induction between March and June 2019. Cervical elastography was applied to patients before induction. Induction success in pregnant women who underwent induction with oxytocin was accepted to be greater than Bishop 9. The cases were divided into two groups as successful (n=28) and unsuccessful (n=28) induction, and their elastosonographic findings were compared. ResultsIn 28 cases with successful induction (Bishop >9, and vaginal delivery occurred in 28), the mean stiffness of the cervix in measurements from four regions was 13.6 ±3.7 kPa in the measurement of the cervix with the elastography method before induction was started, while this value was measured as 14.9 ± 3.1 in cases where induction was unsuccessful (t- value: -1.321, p=0.194). Conclusions Our study showed that pre-induction stiffness of the cervix cannot predict the success of labor induction with oxytocin. More studies with larger samples are needed to arrive at a decent conclusion. In addition, results can be more assuring with the developing technique and sensitivity of elastography.

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Section: Discussionmentioning

confidence: 99%

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Halilzade

HALİLZADE

Sert

et al. 2023

Z Geburtshilfe Neonatol

View full text Add to dashboard Cite

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“…Although other measures of cervical consistency such as elastography exist, they are not currently in common use. [27][28][29] Further research to characterize the predictive value of these objective cervical measures in the late third trimester may help improve the prediction of spontaneous labor onset. Further research is also needed to delineate biological pathways that may explain the association between substance use and spontaneous labor onset.…”

Section: Research Implicationsmentioning

confidence: 99%

Predicting Spontaneous Labor beyond 39 Weeks among Low-Risk Expectantly Managed Pregnant Patients

Sanusi

Battarbee

et al. 2023

Am J Perinatol

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Objectives: To identify characteristics associated with spontaneous labor onset in pregnant patients undergoing expectant management at greater than 39 weeks’ gestation and delineate perinatal outcomes associated with spontaneous labor compared with labor induction. Study design: This was a retrospective cohort study of singleton pregnancies ≥390/7 weeks gestation delivered at a single center in 2013. Exclusion criteria were elective induction, cesarean delivery or presence of a medical indication for delivery at 39weeks, more than one prior cesarean delivery, fetal anomaly or demise. We evaluated prenatally available maternal characteristics as potential predictors of the primary outcome-spontaneous labor onset. Multivariable logistic regression was used to generate two parsimonious models – one with and one without third trimester cervical dilation. We also performed sensitivity analysis by parity and timing of cervical examination, and compared mode of delivery and other secondary outcomes between patients who spontaneous labored and those who did not. Results: Of 707 eligible patients, 536(75.8%) attained spontaneous labor and 171(24.2%) did not. In the first model, maternal BMI, parity and substance use were identified as the most predictive factors. Overall, the model did not predict spontaneous labor(AUC 0.65, 95% CI 0.61-0.70) with high accuracy. The addition of third trimester cervical dilation in the second model did not significantly improve labor prediction(AUC 0.66, 95% CI: 0.61-0.70; p=0.76). These results did not differ by timing of cervical examination or parity. Patients admitted in spontaneous labor had lower odds of cesarean delivery(OR 0.33, 95% CI 0.21-0.53) and NICU admission(OR 0.38, 95% CI 0.15-0.94). Other perinatal outcomes were similar between groups. Conclusions : Maternal characteristics did not predict spontaneous labor onset ≥39 weeks’ gestation with high accuracy. Patients should be counseled on challenges of labor prediction regardless of parity and cervical examination, outcomes if spontaneous labor does not occur and benefits of elective labor induction discussed.

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“…USE is an established method for evaluating cervical softening, predicting pre-term delivery and outcomes of labor induction [ 64 – 75 ]. In 2019, a meta-analysis including 1488 pregnant indicated that cervical USE is useful to PTD with a summary sensitivity of 0.84 [95% confidence interval (CI): 0.68, 0.93], a specificity of 0.82 (95% CI: 0.63, 0.93), a diagnostic odds ratio of 25 (95% CI: 7, 93), and AUC of USE being 0.90 (95% CI: 0.87–0.93) [ 76 ].…”

Section: Predicting Preterm Deliverymentioning

confidence: 99%

Advances in the clinical application of ultrasound elastography in uterine imaging

Wang

Lin

2022

Insights Imaging

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Changes in tissue stiffness by physiological or pathological factors in tissue structure are identified earlier than their clinical features. Pathological processes such as uterine fibrosis, adenomyosis, endometrial lesions, infertility, and premature birth can manifest as tissue elasticity changes. In clinical settings, elastography techniques based on ultrasonography, optical coherence tomography, and magnetic resonance imaging are widely used for noninvasive measurement of mechanical properties in patients, providing valuable tool and information for diagnosis and treatment. Ultrasound elastography (USE) plays a critical role in obstetrics and gynecology clinical work because of its simplicity, non-invasiveness, and repeatability. This article reviews the recent progress of USE in uterine tumor diagnosis (especially early diagnosis and treatment effect evaluation), prediction of preterm birth, and intrauterine insemination. We believe that USE, especially shear wave elastography, may serve as a potential means to assess tissue stiffness, thereby improving the diagnosis and treatment of adenomyosis, fibroids, endometrial lesions, cervical cancer, and precise management of preterm birth and intrauterine insemination monitoring.

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Relationship between cervical elastography and spontaneous onset of labor

Cited by 5 publications

References 23 publications

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Can Transvaginal Cervical Elastography predict the success of induction of labor with oxytocin?

Predicting Spontaneous Labor beyond 39 Weeks among Low-Risk Expectantly Managed Pregnant Patients

Advances in the clinical application of ultrasound elastography in uterine imaging

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