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Cervical Maturity Assessment Based on Ultrasound Elastography E-Cervix: Cluster Analysis.
Ekaterina V Kopteeva1, Vladislava V Khalenko1, Olga V Pachuliia1
1Department of Obstetrics and Perinatology, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, St. Petersburg, Russia.
Summary
Quantitative ultrasound elastography identified three distinct cervical phenotypes during pregnancy. These phenotypes, characterized by cervical length and stiffness, predict spontaneous labor risk, aiding in objective cervical remodeling assessment.
Area of Science:
- Obstetrics and Gynecology
- Medical Imaging
- Biophysics
Background:
- Cervical remodeling is crucial for pregnancy progression.
- Objective assessment of cervical changes is needed.
Purpose of the Study:
- To identify distinct cervical remodeling phenotypes using ultrasound and quantitative elastography.
- To correlate these phenotypes with gestational age, cervical length, and labor risk.
Main Methods:
- Prospective observational study of 373 pregnant women.
- Cervical elastography performed using E-Cervix software.
- Quantitative parameters assessed: hardness ratio (HR), elasticity contrast index (ECI), internal os (IOS), and external os (EOS).
Main Results:
- Cervical hardness (HR) decreased, while heterogeneity (ECI) and deformation (IOS, EOS) increased with gestational age and cervical shortening.
- Three phenotypes identified: 'immature cervix' (long, stiff), 'mature cervix' (short, soft), and an intermediate group.
- The 'mature cervix' phenotype showed the highest risk of spontaneous labor within 14 days.
Conclusions:
- Decreasing HR and increasing ECI, IOS, and EOS signify progressive cervical softening.
- Elastography parameters combined with cervical length objectively assess cervical remodeling.
- Phenotype identification aids in predicting labor risk.
