Measurement of cervical softness before cerclage placement with an aspiration-based device

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Biomedical Engineering

Background:

• Cervical insufficiency is linked to preterm birth, with cervical softness playing a role in its pathophysiology.
• Current methods for measuring cervical softness lack routine clinical application.
• Objective measurement of cervical softness could improve the identification of at-risk pregnancies.

Purpose of the Study:

• To measure cervical softness in patients with cervical insufficiency and healthy controls using a novel aspiration-based device.
• To test the hypothesis that the cervix is softer in patients with cervical insufficiency.

Main Methods:

• A cross-sectional study involving 133 women (54 cerclage patients, 79 controls).
• A noninvasive, aspiration-based device measured cervical softness by quantifying aspiration pressure needed for tissue displacement.
• Cerclage patients were categorized into history-indicated, ultrasound-indicated, and examination-indicated groups; controls were matched by gestational age.

Main Results:

• Patients undergoing ultrasound-indicated cerclage exhibited significantly softer cervices (median 62 mbar) compared to second-trimester controls (median 81 mbar; P=.042).
• No significant differences in cervical softness were found between history-indicated or examination-indicated cerclage groups and their respective controls.
• Data from 133 women were analyzed, with 54 in the cerclage group and 79 controls.

Conclusions:

• An aspiration-based device demonstrated that cervices are significantly softer in patients presenting for ultrasound-indicated cerclage than in normal controls.
• Quantitative measurement of cervical softness using this device is a promising method for objective assessment during pregnancy.
• This technique may aid in identifying pregnancies at risk for cervical insufficiency and subsequent preterm birth.