Use of Cervical Elastography at 18 to 22 weeks gestation in
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According to this study, cervical elastography parameters are reliably measured and are stable across 18-22 weeks gestation. It was published in the American Journal of Obstetrics & Gynecology.

The objective was to develop standard cervical elastography nomograms for singleton pregnancies at 18-22 weeks gestation using the E-cervix ultrasound application; assess intra-observer reliability of the E-cervix elastography parameters, and determine if these cervical elastography measurements can be used in the prediction of spontaneous preterm birth.

This was a prospective cohort study of pregnant women undergoing cervical length screening assessment via transvaginal ultrasound examination at 18 – 22 weeks gestation. A semi-automatic, cervical elastography application (E-cervix) was utilized during the transvaginal examination to calculate five quantitative parameters (Internal Os Stiffness, External Os Stiffness, Internal to External Os Stiffness Ratio, Hardness Ratio, Elasticity Contrast Index) and create a standard nomogram for each one of them.

Cervical elastography parameters were compared between those who delivered preterm (<37 weeks) spontaneously versus full term. 742 women were included of which 49 had spontaneous preterm delivery. A standard nomogram was created for each of the cervical elastography parameters from those who had a full-term birth in the index pregnancy.

--Intra-observer reliability was good or excellent for each of the cervical elastography parameters except External Os Stiffness which was poor.

--In univariate analysis, none of the cervical elastography parameters were associated with a statistically significant increased risk of spontaneous preterm birth.

--In a multivariable model adjusting for history of preterm birth, gravidity, ethnicity, cervical cerclage, and vaginal progesterone use, increasing Elasticity Contrast Index was significantly associated with an increased risk of spontaneous preterm birth.

In particular, cervical elastography parameters are reliably measured and are stable across 18-22 weeks gestation. Based on our findings, the Elasticity Contrast Index was associated with an increased risk for spontaneous preterm birth and may be the parameter useful for future research.

Source: https://doi.org/10.1016/j.ajog.2021.05.017
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