Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor
<b>Background/Objective</b>: Accurately identifying women at high risk for preterm birth among those with threatened preterm labor (PTL) is crucial for effective interventions or tocolytic management to reduce preterm birth and its complications. This study aimed to determine the predict...
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2025-07-01
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| author | Hayan Kwon Ji-Hee Sung Hyun Soo Park Ja-Young Kwon Yun Ji Jung Hyun-Joo Seol Hyun Mi Kim Won Joon Seong Han Sung Hwang Soo-Young Oh on behalf of The Korean Consortium for the Study of Cervical Elastography in Prediction of Preterm Delivery |
| author_facet | Hayan Kwon Ji-Hee Sung Hyun Soo Park Ja-Young Kwon Yun Ji Jung Hyun-Joo Seol Hyun Mi Kim Won Joon Seong Han Sung Hwang Soo-Young Oh on behalf of The Korean Consortium for the Study of Cervical Elastography in Prediction of Preterm Delivery |
| author_sort | Hayan Kwon |
| collection | DOAJ |
| description | <b>Background/Objective</b>: Accurately identifying women at high risk for preterm birth among those with threatened preterm labor (PTL) is crucial for effective interventions or tocolytic management to reduce preterm birth and its complications. This study aimed to determine the predictive value of cervical elastography for preterm delivery before 37 weeks of gestation in patients with threatened PTL and a cervical length greater than 15 mm. <b>Methods</b>: This prospective cohort study included pregnant women presenting with threatened PTL at between 24 and 34 weeks gestation. All participants underwent cervical elastography at diagnosis. We compared cervical elastography parameters between women who delivered spontaneously preterm (<37 weeks) and those who delivered at full term and assessed the ability of these parameters to predict spontaneous preterm delivery. <b>Results</b>: Among the 107 enrolled individuals with threatened PTL and a cervical length of ≥15 mm, 55 (42%) experienced preterm birth (<37 weeks). Internal os stiffness (IOS), internal-to-external os stiffness ratio (IOS/EOS ratio), and elasticity contrast index (ECI) were significantly associated with a risk of preterm birth compared to full-term birth. The IOS/EOS ratio was associated with 10-fold higher odds of preterm birth at <37 weeks (95% confidence interval [CI], 1.82–59.98), and ECI was associated with 1.5-fold higher odds (95% CI, 1.01–2.37). The IOS/EOS ratio demonstrated good predictive value (area under the curve (AUC) = 0.678) and the combination of CL ≤ 25 mm and the IOS/EOS ratio had good diagnostic performance for predicting preterm birth (AUC = 0.708). <b>Conclusions</b>: Cervical elastography using the E-Cervix™ system appears to improve the ability to predict preterm birth in pregnant women with threatened PTL and a cervical length greater than 15 mm. |
| format | Article |
| id | doaj-art-e4a2ba8a38e14fce83276672343e4c6d |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-07-01 |
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| series | Diagnostics |
| spelling | doaj-art-e4a2ba8a38e14fce83276672343e4c6d2025-08-20T04:00:50ZengMDPI AGDiagnostics2075-44182025-07-011515193410.3390/diagnostics15151934Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm LaborHayan Kwon0Ji-Hee Sung1Hyun Soo Park2Ja-Young Kwon3Yun Ji Jung4Hyun-Joo Seol5Hyun Mi Kim6Won Joon Seong7Han Sung Hwang8Soo-Young Oh9on behalf of The Korean Consortium for the Study of Cervical Elastography in Prediction of Preterm DeliveryDepartment of Obstetrics and Gynecology, Yonsei University Health System, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of KoreaFamily Medicine Residency, Providence St. Joseph Eureka Hospital, Eureka, CA 95501, USADepartment of Obstetrics and Gynecology, Yonsei University Health System, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Obstetrics and Gynecology, Yonsei University Health System, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, Daegu 41404, Republic of KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, Daegu 41404, Republic of KoreaDepartment of Obstetrics and Gynecology, Konkuk University Medical Center, Konkuk University School of Medical, Seoul 05030, Republic of KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea<b>Background/Objective</b>: Accurately identifying women at high risk for preterm birth among those with threatened preterm labor (PTL) is crucial for effective interventions or tocolytic management to reduce preterm birth and its complications. This study aimed to determine the predictive value of cervical elastography for preterm delivery before 37 weeks of gestation in patients with threatened PTL and a cervical length greater than 15 mm. <b>Methods</b>: This prospective cohort study included pregnant women presenting with threatened PTL at between 24 and 34 weeks gestation. All participants underwent cervical elastography at diagnosis. We compared cervical elastography parameters between women who delivered spontaneously preterm (<37 weeks) and those who delivered at full term and assessed the ability of these parameters to predict spontaneous preterm delivery. <b>Results</b>: Among the 107 enrolled individuals with threatened PTL and a cervical length of ≥15 mm, 55 (42%) experienced preterm birth (<37 weeks). Internal os stiffness (IOS), internal-to-external os stiffness ratio (IOS/EOS ratio), and elasticity contrast index (ECI) were significantly associated with a risk of preterm birth compared to full-term birth. The IOS/EOS ratio was associated with 10-fold higher odds of preterm birth at <37 weeks (95% confidence interval [CI], 1.82–59.98), and ECI was associated with 1.5-fold higher odds (95% CI, 1.01–2.37). The IOS/EOS ratio demonstrated good predictive value (area under the curve (AUC) = 0.678) and the combination of CL ≤ 25 mm and the IOS/EOS ratio had good diagnostic performance for predicting preterm birth (AUC = 0.708). <b>Conclusions</b>: Cervical elastography using the E-Cervix™ system appears to improve the ability to predict preterm birth in pregnant women with threatened PTL and a cervical length greater than 15 mm.https://www.mdpi.com/2075-4418/15/15/1934threatened preterm laborelastographypreterm birthtransvaginal ultrasoundcervical length |
| spellingShingle | Hayan Kwon Ji-Hee Sung Hyun Soo Park Ja-Young Kwon Yun Ji Jung Hyun-Joo Seol Hyun Mi Kim Won Joon Seong Han Sung Hwang Soo-Young Oh on behalf of The Korean Consortium for the Study of Cervical Elastography in Prediction of Preterm Delivery Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor Diagnostics threatened preterm labor elastography preterm birth transvaginal ultrasound cervical length |
| title | Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor |
| title_full | Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor |
| title_fullStr | Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor |
| title_full_unstemmed | Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor |
| title_short | Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor |
| title_sort | diagnostic efficacy of cervical elastography in predicting spontaneous preterm birth in pregnancies with threatened preterm labor |
| topic | threatened preterm labor elastography preterm birth transvaginal ultrasound cervical length |
| url | https://www.mdpi.com/2075-4418/15/15/1934 |
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