Quantitative Stress-Strain Cervical Elastography Characterizes Cervical Remodeling in Pregnancy

Area of Science:

• Biomedical Engineering
• Obstetrics and Gynecology
• Medical Imaging

Background:

• Current elastography methods lack repeatability, hindering longitudinal and cross-patient comparisons for defining cervical norms.
• A standardized, quantitative method is needed to assess cervical biomechanical changes during pregnancy for clinical and research advancements.

Purpose of the Study:

• To evaluate a novel quantitative, synchronized stress-strain cervical elastography system (FQ-CES) for longitudinal quantification of cervical remodeling in human pregnancies.
• To describe cervical remodeling patterns in relation to term and preterm birth outcomes.

Main Methods:

• A prospective, longitudinal, multicenter study involving pregnant individuals with singleton gestations.
• Quantitative stress-strain cervical elastography exams were performed at up to three time points during pregnancy.
• Linear mixed effects models analyzed cervical softening patterns and compared them between term and preterm birth groups, also comparing with cervical length.

Main Results:

• The FQ-CES system demonstrated statistically significant, steady cervical softening throughout pregnancy (approx. 7.4% per week).
• Nulliparous individuals had significantly softer cervices at the start of pregnancy compared to multiparous individuals.
• Individuals with preterm birth exhibited softer cervices and a flatter softening slope compared to those with term birth, who had firmer cervices and a steeper slope.

Conclusions:

• Quantitative cervical elastography with synchronized stress-strain measurement reliably quantifies longitudinal cervical remodeling patterns comparable across populations.
• This elastography device detects more significant differences between term and preterm birth outcomes than cervical length measurements.
• The FQ-CES system represents a technological advancement for improved preterm birth risk prediction.