Prognostic value of elastography in predicting premature delivery

The aim of the study was to assess changes in the consistency of the uterine cervix and correlate the obtained results with the risk of premature delivery and time from examination to delivery

Elastographic images of the cervix in a group of 44 patients, admitted to the hospital due to uterine contractions before 37 weeks of gestation, were recorded and analyzed. Elastograms were assessed with the use of Elastography Index (El), a five-step (0-4) color scale, which visualizes tissue hardness by encoding numerical values in specific colors (0-violet/the hardest tissue; 4-red/the softest tissue). Correlation between El for different parts of the uterine cervix was evaluated and analyzed in relation to preterm delivery and time from examination to delivery.

Twenty-one patients delivered before term and 23 at term. A strong correlation for El of the internal os and time from examination to delivery (Pearson test, p<0.001), and risk of preterm birth (Mann-Whitney-Wilcoxon test, p<0.001), was noted. We also found a strong correlation between cervical canal length and risk of preterm delivery (Anova test, p=0.001), and time from examination to delivery (Pearson test, p=0.006).

Elastography may offer a chance for an objective assessment of elasticity of the uterine cervix and may become an alternative to vaginal examination and Bishop score. Proper selection of patients with high or low risk of preterm delivery may facilitate good management decisions and, consequently decrease the percentage of immature deliveries, unnecessary medical procedures, and hospitalization.