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Novel measures of cervical deformation properties on transvaginal ultrasound and prediction of time to delivery

Zhao, Peinan and Gao, Hansong and Pizzella, Stephanie and Diveley, Emily and Hardy, Cassandra and Hu, Peng and Tuuli, Methodius G. and Stout, Molly J. (2021) Novel measures of cervical deformation properties on transvaginal ultrasound and prediction of time to delivery. American Journal of Obstetrics and Gynecology, 224 (2). S610-S611. ISSN 0002-9378. https://resolver.caltech.edu/CaltechAUTHORS:20210201-124808908

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Abstract

Objective: To examine deformation characteristics of the cervix during transvaginal ultrasound (TVUS), as a surrogate for cervical softening, in relation to time to delivery. Study Design: Prospective cohort study of patients undergoing longitudinal cervical imaging. We assessed TVUS exams from 20 weeks to within 1 week of delivery. B-mode video captured standard cervical length (CL) views including the cervical canal, and internal and external os under pressure and release cycles. Cervical deformation characteristics were: CL length stretch ratio defined as CL at the highest pressure divided by CL at the lowest pressure (as the cervix becomes softer it elongates more with pressure), and Anterior-posterior cervical thickness ratio defined as thickness of the anterior layer of cervix divided by thickness of the posterior layer (as the cervix softens, pressure on anterior layer is not transmitted effectively to the posterior layer and it is less compressed) (Fig. 1). These measures were compared between time windows to assess progression of cervical softness as pregnancy progressed in term(T) and spontaneous preterm (PT) births. Results: 160 patients were included; 114 T and 46 PT births. In both T and PT births, the CL stretch ratio significantly increased 1-2 weeks before delivery compared to 3-4 weeks. The anterior-posterior thickness ratio also significantly decreased 1-2 weeks before delivery in T birth. Measures at all time points from 3 to 20 weeks before delivery did not significantly differ, suggesting that cervical softening occurs proximal to delivery in both T and PT births (Fig 2). Measures in T and PT births were similar distant from delivery (3-20 weeks) and proximal to delivery (within 2 weeks), suggesting that cervical ripening patterns are similar, but occur earlier in PT births. Conclusion: We report novel measures of cervical deformation properties easily obtained by TVUS that change 1-2 weeks before delivery. These measures warrant further investigation for clinical application to detect timing of both T and PT deliveries.


Item Type:Article
Related URLs:
URLURL TypeDescription
https://doi.org/10.1016/j.ajog.2020.12.1009DOIArticle
ORCID:
AuthorORCID
Hu, Peng0000-0002-2933-1239
Stout, Molly J.0000-0001-5171-313X
Additional Information:© 2020 Published by Mosby, Inc. Available online 1 February 2021.
Issue or Number:2
Record Number:CaltechAUTHORS:20210201-124808908
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20210201-124808908
Official Citation:Peinan Zhao, Hansong Gao, Stephanie Pizzella, Emily Diveley, Cassandra Hardy, Peng Hu, Methodius G. Tuuli, Molly J. Stout, 984 Novel measures of cervical deformation properties on transvaginal ultrasound and prediction of time to delivery, American Journal of Obstetrics and Gynecology, Volume 224, Issue 2, Supplement, 2021, Pages S610-S611, ISSN 0002-9378, https://doi.org/10.1016/j.ajog.2020.12.1009.
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:107837
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:01 Feb 2021 21:38
Last Modified:01 Feb 2021 21:38

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