Mazza Edoardo, Parra-Saavedra Miguel, Bajka Michael, Gratacos Eduard, Nicolaides Kypros, Deprest Jan
Prenat Diagn. 2014 Jan;34(1):33-41. doi: 10.1002/pd.4260.
Measuring the stiffness of the cervix might be useful in the prediction of preterm delivery or successful induction of labor. For that purpose, a variety of methods for quantitative determination of physical properties of the pregnant cervix have been developed. Herein, we review studies on the clinical application of these new techniques. They are based on the quantification of mechanical, optical, or electrical properties associated with increased hydration and loss of organization in collagen structure. Quasi-static elastography determines relative values of stiffness; hence, it can identify differences in deformability. Quasi-static elastography unfortunately cannot quantify in absolute terms the stiffness of the cervix. Also, the current clinical studies did not demonstrate the ability to predict the time point of delivery. In contrast, measurement of maximum deformability of the cervix (e.g. quantified with the cervical consistency index) provided meaningful results, showing an increase in compliance with gestational age. These findings are consistent with aspiration measurements on the pregnant ectocervix, indicating a progressive decrease of stiffness along gestation. Cervical consistency index and aspiration measurements therefore represent promising techniques for quantitative assessment of the biomechanical properties of the cervix.
测量宫颈硬度可能有助于预测早产或引产成功。为此，已开发出多种定量测定妊娠宫颈物理特性的方法。在此，我们综述这些新技术临床应用的研究。它们基于对与胶原结构中水分增加和结构丧失相关的机械、光学或电学特性的量化。准静态弹性成像可确定硬度的相对值，因此，它能识别变形能力的差异。遗憾的是，准静态弹性成像无法绝对量化宫颈的硬度。而且，目前的临床研究并未证明其具有预测分娩时间点的能力。相比之下，测量宫颈的最大变形能力（如用宫颈质地指数量化）提供了有意义的结果，显示顺应性随孕周增加。这些发现与对妊娠宫颈外口的抽吸测量结果一致，表明随着孕周增加，硬度逐渐降低。因此，宫颈质地指数和抽吸测量是定量评估宫颈生物力学特性的有前景的技术。
