Quantitative elastography of cervical stiffness during the three trimesters of pregnancy with a semiautomatic measurement program: A longitudinal prospective pilot study

Aim To assess the reproducibility of a semiautomatic quantification tool for cervical stiffness and evaluate the normal changes in cervical elasticity during the three trimesters of pregnancy. Methods This longitudinal prospective pilot study evaluated cervical elasticity during the three trimesters...

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Published in:The journal of obstetrics and gynaecology research 2020-02, Vol.46 (2), p.237-248
Main Authors: Du, Liu, Lin, Mei‐Fang, Wu, Li‐Hong, Zhang, Li‐He, Zheng, Qiao, Gu, Yu‐Jun, Xie, Hong‐Ning
Format: Article
Language:English
Subjects:
Cervical cancer
Cervix
Cysts
elastography
Operators
Pregnancy
Reproducibility
strain
transvaginal ultrasound
Tumors
Uterus
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Summary:Aim To assess the reproducibility of a semiautomatic quantification tool for cervical stiffness and evaluate the normal changes in cervical elasticity during the three trimesters of pregnancy. Methods This longitudinal prospective pilot study evaluated cervical elasticity during the three trimesters of pregnancy (11–14, 20–24 and 28–32 weeks) in women with singleton pregnancies. Women with a history of conization, cerclage, cervical Naboth cysts (diameter > 10 mm), cervical tumors, or uterine malformation were excluded. A semiautomatic tool was used to evaluate the stiffness of the whole cervix and the internal and external cervical os with multiple quantitative elasticity parameters and the cervical length (CL) on the sagittal view via transvaginal elastography. Intraclass correlation coefficients (ICC) and Bland–Altman analysis were used to assess intra‐ and interobserver variability. E‐Cervix parameters during the three trimesters were compared using the Friedman test. Results In total, 217 women with 651 strain examinations during the three trimesters were included. The intra‐ and interobserver ICC for the E‐Cervix parameters ranged from 0.947 to 0.991 and 0.855 to 0.989, respectively. There were significant differences in all parameters among the three trimesters. Cervical elasticity showed significant softening and became heterogeneous during the three trimesters. The median CL was significantly shorter in the first trimester than in the second and third trimesters (P = 0.004, P
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.14170