E-Cervix Assessment of Cervical Softening During Medication Abortion: A Single-Center Observational Study

Cervical softening is essential for successful medication abortion in early pregnancy, yet existing assessments do not adequately quantify biomechanical changes in cervical tissue. This study primarily aimed to characterize cervical changes before and after medication abortion using E-Cervix, with an exploratory secondary analysis of their association with cumulative carboprost methylate suppository dose.

This single-center observational pre-post study included 91 women undergoing medication abortion in early pregnancy. All participants received the same mifepristone regimen, and the cumulative carboprost methylate dose ranged from 0.5 to 3.5 mg. Pre-post changes in six cervical parameters were evaluated, and baseline-adjusted linear regression was used to compare the 0.5-1 mg and >1 mg groups.

After medication abortion, ECI increased by 0.92 (95% CI, 0.68-1.16), HR decreased by 0.18 (95% CI, 0.15-0.20), IOS increased by 0.11 (95% CI, 0.08-0.13), and EOS increased by 0.08 (95% CI, 0.06-0.10); CL shortened, and the IOS/EOS ratio increased. The FDR-adjusted P values for all six comparisons were <0.05. The 0.5-1 mg and >1 mg groups included 68 and 23 participants, respectively; after baseline adjustment, dose group was not significantly associated with any post-treatment cervical parameter.

E-Cervix quantitatively characterized multidimensional cervical softening during medication abortion, supporting its potential utility for objective assessment of cervical changes. In the exploratory observational dose analysis, no association was observed between higher cumulative carboprost methylate dose and greater cervical softening.