Assessment of cervical elastography strain pattern and its association with preterm birth

2017 ◽  
Vol 45 (8) ◽  
Author(s):  
Vera Oturina ◽  
Kerstin Hammer ◽  
Mareike Möllers ◽  
Janina Braun ◽  
Maria Karina Falkenberg ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Strain Ratio ◽  
Cervical Length ◽  
Ultrasound Elastography ◽  
Observer Variability ◽  
Spontaneous Preterm Birth ◽  
Predictive Values ◽  
Strain Pattern ◽  
Spontaneous Preterm Delivery

AbstractObjective:The aim of the study was to assess the cervical strain pattern by an ultrasound elastography cervix examination and to determine its association with preterm delivery.Methods:In this study, 30 cases resulting in preterm birth and 30 gestational age-matched controls were included. A vaginal ultrasound examination with cervical length and elastography measurement was performed. We calculated four strain ratios (SR1–SR4) of the regions of interest (ROIs) arranged in pairs in four different positions on the anterior cervical lip. The strain ratios were correlated to the outcome of spontaneous preterm delivery. The inter-observer and intra-observer variability of the strain measurement was evaluated.Results:We observed an association between the value of the strain ratio that was calculated from the ROIs placed side by side in the middle of the anterior lip (SR4), and preterm delivery (P<0.001). The predictive values of cervical length and SR4 were comparable (AUC 0.7394; AUC 0.8322, respectively). The combination of cervical length and SR4 was superior in predicting preterm delivery compared to both parameters alone (AUC 0.8789). The inter-observer and intra-observer variability of data acquisition and measurement was excellent.Conclusions:Our study assesses the cervical elastography strain pattern and shows a correlation to a spontaneous preterm birth.

scholarly journals Association Between Cervical Length at 18-23 Weeks of Gestation and Spontaneous Preterm Delivery: A Cross Sectional Study

2020 ◽  
pp. 1-4
Author(s):  
Trupti Ruge ◽  
Trupti Ruge ◽  
Emanuel Gracias
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Transvaginal Ultrasound ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Cervical Length ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Spontaneous Preterm Delivery

Introduction: Preterm birth is childbirth occurring at less than 37 completed weeks or 259 days of gestation, is a major determinant of neonatal mortality and morbidity and has long-term adverse consequences for health. Identifying ways to address preventable causes of preterm birth should be a top priority in developing regions of the world. the present study was planned to find the association between cervical length at 18 to 23 weeks of gestation done as a routine during all second level scans and spontaneous preterm delivery. Patients and Methods: This is a hospital based cross sectional study conducted during the period from January 2019 to December 2019. A total of 205 women presenting with singleton pregnancies between 18- 23 weeks of gestations were assessed by transvaginal ultrasound for the measurement of cervical length. Patients were interviewed and their demographic data such as age, obstetric index(GPALD), obstetric history such last menstrual period (LMP), estimated delivery date (EDD) and current pregnancy details such as BP, pulse rate, pallor, period of gestation, were recorded in a predesigned pro forma. Results: In a total of 205 subjects, the average age was found to be 23.26 ± 3.49 years with 52.2% of the women being primigravida. The mean gestation age at the time of enrollment was 20.72 ± 1.00 weeks with 33% of women showing a cervical length of 26-30 mm. The delivery outcome was found as 11% preterm, majority (89.27%) was term delivery. Conclusion: The present study showed that a significantly higher number of women with cervical length ≤ 30 mm (assessed at 18 to 23 weeks of gestation) had preterm labour compared to a woman with cervical length > 30 mm.

Correlation of cervical length, fetal fibronectin, phIGFBP-1, and cytokines in spontaneous preterm birth up to 14 days from sampling

2015 ◽  
Vol 43 (5) ◽  
Author(s):  
Marija Hadži-Lega ◽  
Ana Daneva Markova ◽  
Milan Stefanovic ◽  
Mile Tanturovski
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Labor ◽  
Cervical Length ◽  
Outcome Variable ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Tnf Α ◽  
Vaginal Swabs ◽  
The Relationship

AbstractThe aim of this study was to determine the relationship between sonographic cervical length, fetal fibronectin (fFN), phIGFBP-1 (actim partus test), cytokines (IL-6, IL-2R, and TNF-α), and spontaneous preterm birth (SPTB) up to 14 days from sampling.Fifty-eight patients were recruited in a period of 6 months from September 2013 until March 2014 with symptoms or complaints suggestive of preterm labor. Consenting women were treated according to usual hospital protocol, with addition of vaginal swabs taken for fetal fibronectin, phIGFBP-1 (actim partus test) and cervical IL6, IL2R, and TNF-α. The outcome variable was occurrence of preterm delivery within 14 days from the day of hospital admission.Thirty-six patients (62.07%) were delivered within 14 days from admission. Our results indicated that the cervical length significantly inversely correlates with the concentration of IL-6 in the CVF (Spearman’s coefficient R=–0.382, P<0.05). Cervical length also correlated with a positive phIGFBP-1 test, i.e., patients with a positive test had an average cervical length of 18.5±4.63 mm, which is significantly lower than patients with a negative test –23.43±7.39 mm (P=0.003).The studied biochemical markers were only moderately successful in the prediction of preterm delivery.

scholarly journals Spontaneous preterm delivery is reflected in both early neonatal and maternal gut microbiota

2021 ◽  
Author(s):  
Henni Hiltunen ◽  
Maria Carmen Collado ◽  
Helena Ollila ◽  
Terhi Kolari ◽  
Satu Tölkkö ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gut Microbiota ◽  
Preterm Delivery ◽  
Preterm Neonates ◽  
Delivery Mode ◽  
Microbiota Composition ◽  
Spontaneous Preterm Birth ◽  
Spontaneous Preterm Delivery ◽  
Gut Colonization ◽  
Gut Microbiota Composition

Abstract Background Aberrant gut microbiota composition in preterm neonates is linked to adverse health consequences. Little is known about the impact of perinatal factors or maternal gut microbiota on initial preterm gut colonization. Methods Fecal samples were collected from 55 preterm neonates (<35 gestational weeks), 51 mothers, and 25 full-term neonates during the first 3–4 postpartum days. Gut microbiota composition was assessed using 16S ribosomal RNA gene sequencing. Results Preterm neonates exhibited significantly lower gut microbiota alpha diversity and distinct beta diversity clustering compared to term neonates. Spontaneous preterm birth was associated with distinct initial gut microbiota beta diversity as compared to iatrogenic delivery. Gestational age or delivery mode had no impact on the preterm gut microbiota composition. The cause of preterm delivery was also reflected in the maternal gut microbiota composition. The contribution of maternal gut microbiota to initial preterm gut colonization was more pronounced after spontaneous delivery than iatrogenic delivery and not dependent on delivery mode. Conclusions The initial preterm gut microbiota is distinct from term microbiota. Spontaneous preterm birth is reflected in the early neonatal and maternal gut microbiota. Transmission of gut microbes from mother to neonate is determined by spontaneous preterm delivery, but not by mode of birth. Impact The initial gut microbiota in preterm neonates is distinct from those born full term. Spontaneous preterm birth is associated with changes in the gut microbiota composition of both preterm neonates and their mothers. The contribution of the maternal gut microbiota to initial neonatal gut colonization was more pronounced after spontaneous preterm delivery as compared to iatrogenic preterm delivery and not dependent on delivery mode. Our study provides new evidence regarding the early gut colonization patterns in preterm infants. Altered preterm gut microbiota has been linked to adverse health consequences and may provide a target for early intervention.

Evaluation of Cervical Elastography Strain Pattern to Predict Preterm Birth

2019 ◽  
Vol 41 (04) ◽  
pp. 397-403
Author(s):  
Anna Gesthuysen ◽  
Kerstin Hammer ◽  
Mareike Möllers ◽  
Janina Braun ◽  
Kathrin Oelmeier de Murcia ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Area Under The Curve ◽  
Predictive Marker ◽  
Strain Ratio ◽  
Cervical Length ◽  
Strain Pattern ◽  
Spontaneous Preterm Delivery ◽  
Index Strain ◽  
Normal Controls ◽  
Control Study

Abstract Purpose To evaluate cervical elastography strain pattern as a predictive marker for spontaneous preterm delivery (SPTD). Materials and Methods In this case-control study cervical length (CL) and elastographic data (strain ratio, elastography index, strain pattern score) were acquired from 335 pregnant women (20th – 34th week of gestation) by transvaginal ultrasound. Data of 50 preterm deliveries were compared with 285 normal controls. Strain ratio and elastography index were calculated by placing two regions of interest (ROIs) in parallel on the anterior cervical lip. The strain ratio was determined by dividing the higher strain value by the lower one. The elastography index was defined as the maximum of the strain ratio curve. Elastographic images were assigned a new established strain pattern (SP) score between 0 and 2 according to the distribution of strain induced by compression. Results Elastography index, SP score and CL differed between preterm and normal pregnancies (1.61 vs. 1.27, p < 0.001; SP score value of “2”: n = 31 (62 %) vs. n = 36 (12.6 %), p < 0.001; CL 30.7 vs. 41.0 mm, p < 0.001; respectively). The elastography index and SP score were associated with a higher predictive potential than CL measurement alone (AUC 0.8059 (area under the curve); AUC 0.7716; AUC 0.7631; respectively). A combination of all parameters proved more predictive than any single parameter (AUC 0.8987; respectively). Conclusion Higher elastography index and SP scores were correlated with an elevated risk of SPTD and are superior to CL measurement as a predictive marker. A combination of these parameters could be used as a “Cervical Index” for the prediction of SPTD.

Cervical Assessment via Ultrasound Elastography: Calibrated Reference Material Development

2013 ◽  
Author(s):  
Brandi N. Briggs ◽  
Meghan Donnelly ◽  
Virginia L. Ferguson
Keyword(s):  
Preterm Delivery ◽  
Cervical Length ◽  
Ultrasound Elastography ◽  
Cervical Ripening ◽  
Structural Function ◽  
Third Trimester ◽  
Short Cervix ◽  
Material Development ◽  
Spontaneous Preterm Delivery ◽  
Human Cervix

The human cervix serves a dual structural function throughout pregnancy. Prior to term, the cervix remains closed and firm to support the increasing weight of the fetus. At term, it must soften ( i.e., ripen) and dilate to permit birth. Timing of cervical ripening is critical for pregnancy outcome. Cervical insufficiency, or preterm ripening, is diagnosed if a cervix is not stiff enough to support the pregnancy to term and may cause miscarriage or preterm labor. This is sometimes observed mid-pregnancy when funneling at the internal os or shortening of the cervix is observed during a routine ultrasound. Women with a shorter cervix are at a higher risk for spontaneous preterm delivery. 1,2 While cervical length is not a definitive predictor of preterm delivery, a short cervix increases the risk. Moreover, the exact length at which the cervix is considered to be ‘short’ is poorly defined. While transvaginal B-mode ultrasound can identify a short cervix, this procedure is performed when clinically indicated. Cervical ripening and effacement is asymptomatic and thus is often missed until after a patient has suffered a second or third trimester miscarriage.

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

2008 ◽  
Vol 11 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Katharina Klein ◽  
Hubertus Gregor ◽  
Kora Hirtenlehner-Ferber ◽  
Maria Stammler-Safar ◽  
Armin Witt ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Smoking Habit ◽  
Cervical Length ◽  
Spontaneous Preterm Delivery ◽  
Spontaneous Labour ◽  
High Incidence ◽  
High Cervical ◽  
Twin Pregnancies ◽  
Preterm Rupture Of Membranes ◽  
Spontaneous Delivery

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Marlit Karen Strobel ◽  
Maria Eveslage ◽  
Helen Ann Köster ◽  
Mareike Möllers ◽  
Janina Braun ◽  
...  
Keyword(s):  
Strain Ratio ◽  
Cervical Length ◽  
Transformation Process ◽  
Induction Of Labour ◽  
Bishop Score ◽  
Cervical Tissue ◽  
Strain Pattern ◽  
Successful Induction ◽  
Study Population ◽  
First Time

AbstractObjectivesThe aim of this study was to introduce cervical strain elastography to objectively assess the cervical tissue transformation process during induction of labour (IOL) and to evaluate the potential of cervical elastography as a predictor of successful IOL.MethodsA total of 41 patients with full-term pregnancies elected for an IOL were included. Vaginal ultrasound with measurement of cervical length and elastography and assessment of the Bishop Score were performed before and 3 h after IOL. The measured parameters were correlated to the outcome of IOL and the time until delivery.ResultsWe observed an association between the strain pattern and the value of the strain ratio 3 h after IOL and a successful IOL (p=0.0343 and p=0.0342, respectively) which can be well demonstrated by the results after 48 h. In our study population the cervical length and the Bishop Score did not prove to be relevant parameters for the prediction of a successful IOL.ConclusionsWe demonstrated for the first time that the cervical elastography pattern after the first prostaglandine application can help predict the outcome of IOL.

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