The utility of cervical elastosonography in prediction of cervical insufficiency: cervical elastosonography and cervical insufficiency

Öcal, Fatma Doğa; Çekmez, Yasemin; Erdoğdu, Emre; Gezer, Murad; Fanuscu, İnci; Özkan, Handan; Kara, Osman; Küçüközkan, Tuncay

doi:10.3109/14767058.2014.933801

Cited by 15 publications

(15 citation statements)

References 32 publications

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“…However, this treatment is usually ineffective when the cervix has been already shortened and dilated. The first report documenting application of elastography in prediction of cervical incompetence in non-pregnant cervix was published in 2015 37. Although still not verified in a clinical setting, prophylactic administration of progesterone to women presenting with soft internal os before becoming pregnant seems to be a promising option in the prevention of cervical incompetence.…”

Section: Cervical Incompetencementioning

confidence: 99%

Cervical elastography during pregnancy: clinical perspectives

Swiatkowska‐Freund¹,

Preis²

2017

IJWH

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Uterine cervix is a part of the uterus responsible for maintaining pregnancy till term. As long as the cervix remains long and firm and its internal orifice (os) is closed, it can withstand enlargement of the uterine contents and resultant growing pressure. Mechanical properties of the cervix change during pregnancy; the cervix ripens prior to delivery, then effaces and dilates with contractions of the uterus. Ripening of the cervix can be assessed using the Bishop score and ultrasonographically determined length of the cervical canal and internal os. Consistency is one of the cervical properties that change during the course of the maturation process. Until recently, cervical consistency has been assessed only manually, but in 2007, the first report on elastographic imaging of the cervix during pregnancy has been published. Elastography presents the ability of a tissue to deform under pressure. The softer the tissue, the easier it changes its shape. Different methods of elastography are used – static, when tissue displacement in response to manual compression or physiological movements of vessels is measured, or dynamic, when the speed of shear wave propagation is determined. Irrespective of the method, elastography provides information on the internal os stiffness; this parameter, impossible for manual assessment, was shown to correlate with pregnancy outcome and is a strong predictor of preterm delivery or successful labor induction. Although elastography seems to be a highly promising diagnostic option, still no consensus has been reached regarding an optimal method for uterine cervix assessment, and virtually all previous studies of various elastographic methods produced highly satisfactory results. Future studies need to identify the most promising and objective elastographic method which may serve as a novel tool for pregnancy management, preventing adverse events, such as preterm delivery and unsuccessful labor induction.

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Section: Cervical Incompetencementioning

confidence: 99%

Cervical elastography during pregnancy: clinical perspectives

Swiatkowska‐Freund¹,

Preis²

2017

IJWH

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“…Previously, Swiatkowska‐Freund et al used elastography on 29 singleton pregnant women before induction of labor, and demonstrated that the cervical tissue was softer in patients with successful inductions than in patients with failed inductions . Previous studies have focused on the association between cervical elastographic measurements and cervical insufficiency or preterm labor . A recent study conducted by Öcal et al on 20 women with the diagnosis of cervical insufficiency, where the authors compared the elastography measurements with the control subjects, revealed that the internal parts of the cervix were softer than the external parts in patients with a history of cervical insufficiency.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, the source of the mechanical activity during the delivery of the fetus is triggered in the fundus, which makes the fundus the most significant part of myometrium. Premature uterine contractions with sufficient frequency and intensity begin from the uterine fundus, leading to a shortening of the cervix and thus preterm labor . Ozkaya et al , investigating the association between uterine myometrial elastosonography and cervical length, demonstrated that the elasticity of the uterine myometrium is closely correlated with cervical length …”

Section: Introductionmentioning

confidence: 99%

Can myometrial elasticity, as determined by elastography at 18–22 weeks of gestation, predict preterm delivery?

Doğru

Albayrak

Delibaş

et al. 2016

J of Obstet and Gynaecol

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Aim The aim of this study was to determine whether elastographic evaluation of uterine myometrium can predict preterm delivery. Methods This study was carried out at the Department of Obstetrics and Gynecology, Gaziosmanpasa University Hospital, Tokat, Turkey. A total of 148 pregnant women matching the inclusion criteria between January 2014 and January 2015 were enrolled. Elastographic measurements were obtained between 18 and 22 weeks of gestation, on real‐time images by a radiologist. Patients were followed up until delivery. A receiver–operator curve was used to calculate the sensitivity and specificity of the elastographic outcomes. All analyses were completed by spss 20.0. Results A negative correlation existed between the ratio of myometrium strain to fat tissue strain and delivery week (r = −0.300, P = 0.000214). In addition, a positive correlation was found between the ratio of myometrium strain to fat tissue strain and presence of preterm delivery (r = 0.223, P = 0.006). The multivariate linear regression analysis showed that the ratio of myometrium strain to fat tissue strain (β = 0.233, P = 0.006) was the significant predictor for preterm delivery. Conclusion The ratio of myometrium strain to fat tissue strain showed a trend towards significance to predict preterm delivery.

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“…In our previous study, we evaluated the cervix in women who experienced pregnancy loss related to cervical insufficiency (10).…”

Section: Discussionmentioning

confidence: 99%

“…There are reports about the use of ES for differential diagnosis of masses in breast and thyroid imaging. Also, applications in gynecology and obstetrics have been reported (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Elastosonographic Evaluation of Cervix in Idiopathic Recurrent Spontaneous Miscarriage in the First Trimester

Öcal¹,

Çekmez²,

Türkyılmaz³

et al. 2016

Haseki

Self Cite

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ÖzAmaç: İlk trimesterde tekrarlayan idiyopatik spontan düşükleri olan kadınlarda servikal elastosonografinin klinik ve tanısal önemini belirlemek.Yöntemler:Toplam 40 hasta çalışmaya alındı. Bunlardan 20 tanesi ilk trimesterde tekrarlayan idiyopatik spontan düşükleri olan kadınlar ve 20 tanesi de bir kez doğum yapmış sağlıklı kadınlardı. Tüm hastalara servikal elastografi uygulandı. Her hasta için doku gerginlik oranları elde edildi. Bulgular: Elastosonografik ölçüm sonuçlarına göre idiyopatik tekrarlayan gebelik kaybı olan kadınlarda serviksin üst ve dış kısmının iç ve alt kısımlarından daha yumuşak olduğu saptandı. Ancak düşük yapmamış kadınlarda da sonuçlar farklı değildi. Gruplar arasında servikal uzunluk ve elastisite açısından istatistiksel anlamlı fark saptanmadı. Sonuç:Her ne kadar idiyopatik tekrarlayan gebelik kaybı olan kadınlarda A bölgesini C ve D bölgelerinden daha yumuşak bulmuşsak da düşük yapmamış kadınlarda da benzer sonuçlar bulduk. Bizim sonuçlarımız idiyopatik tekrarlayan spontan düşüklerin etyopatogenezinin belirlenmesinde servikal elastisitenin rolü olmadığını göstermektedir. Geniş hasta sayısına sahip ileri çalışmalara ihtiyaç vardır.Anahtar Sözcükler: Elastosonografi, idiyopatik tekrarlayan düşükler, serviks, elastografi Aim: To detect prognostic role of cervical elastosonography (ES) among women with a history of idiopathic recurrent spontaneous miscarriage (IRSM) in early pregnancy.Methods: There were 40 women enrolled in the study. Of the 40, 20 were women diagnosed with IRSM in the first trimester and 20 were healthy women who had at least one childbirth experience. All patients underwent ES evaluation of the cervix. Strain ratio values of certain cervical tissue were recorded for all women. Results:The results of elastosonographic measures showed that external part of the upper lip of the cervix was significantly softer than the internal part and lower lip in women with IRSM. However, for women who had not experienced miscarriage, the results were not different. There were no significant differences observed between cervical length and elasticity among either group. Conclusion:Although we found that Region A was softer than Region C and D in women with IRSM, we also found similar results for women who have not experienced miscarriage. Our results support that cervical elasticity may not play a central role in the detection of etiopathogenesis of IRSM. Further studies with larger groups are needed.

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The utility of cervical elastosonography in prediction of cervical insufficiency: cervical elastosonography and cervical insufficiency

Abstract: According to our knowledge, this is preliminary study to evaluate the predictive value of cervical ES in CI and we concluded that ES can be used as reliable method to determine CI but it is necessary to be studied in different cohort groups.

Cited by 15 publications

References 32 publications

Cervical elastography during pregnancy: clinical perspectives

Cervical elastography during pregnancy: clinical perspectives

Can myometrial elasticity, as determined by elastography at 18–22 weeks of gestation, predict preterm delivery?

Diagnostic Value of Elastosonographic Evaluation of Cervix in Idiopathic Recurrent Spontaneous Miscarriage in the First Trimester

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