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Quantification of cervical stiffness changes in single and twin pregnancies using the E-Cervix technique
Yan Liu1, Dan Yang1, Yu Jiang1
1Department of Ultrasound, Dalian Women and Children's Medical Group, Dalian, China (Dr Liu, Ms Yang, and Ms Jiang).
American Journal of Obstetrics & Gynecology MFM
|November 13, 2022
Summary
Transvaginal ultrasound E-Cervix quantitatively assesses cervical stiffness. Reduced cervical hardness and increased internal os strain in pregnant women are associated with preterm birth risk, offering a new prediction method.
Area of Science:
- Obstetrics and Gynecology
- Medical Imaging
- Perinatal Medicine
Background:
- Cervical length is a standard clinical indicator for preterm birth prediction.
- However, cervical length may not change in cases of cervical insufficiency.
- Quantitative assessment of cervical elasticity offers a potential alternative or adjunct measure.
Purpose of the Study:
- To quantitatively evaluate cervical stiffness using transvaginal ultrasound E-Cervix in singleton and twin pregnancies.
- To establish reference ranges for cervical elasticity parameters across gestational ages.
- To compare cervical elasticity between singleton and twin pregnancies and between preterm and full-term births for improved preterm birth prediction.
Main Methods:
- Transvaginal ultrasonographic E-Cervix assessments were performed on 770 pregnant women.
- Collected data included cervical length, cervical hardness ratio, mean internal os strain, and mean external os strain.
- Statistical analyses compared parameters across different gestational ages, pregnancy types (singleton vs. twin), and birth outcomes (preterm vs. full-term).
Main Results:
- Cervical length and hardness ratio decreased with advancing gestational age, while internal os strain and external os strain increased.
- Twin pregnancies showed lower cervical hardness ratio and higher internal os strain compared to singleton pregnancies.
- Pregnant women experiencing preterm births had a significantly lower cervical hardness ratio and higher internal os strain than those with full-term births.
Conclusions:
- E-Cervix provides quantitative cervical elasticity parameters that change predictably with gestational age.
- Cervical elasticity differs between singleton and twin pregnancies, with greater changes observed in twin gestations.
- Reduced cervical hardness ratio and increased internal os strain are significant indicators associated with preterm birth, regardless of pregnancy type.
