Suthasmalee Sasiwan, Moungmaithong Sakita
Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Obstet Gynaecol Res. 2019 Nov;45(11):2158-2168. doi: 10.1111/jog.14094. Epub 2019 Aug 15.
The aim of this study was to compare shear wave cervical elasticity between term and preterm delivery group.
A prospective cohort study was conducted in enrolled 158 pregnant women at 18-24 weeks of gestation who come for second trimester scan consecutively. Transvaginal ultrasonography for cervical length as well as cervical elasticity in five regions of interest was performed. Intraobserver and interobserver reproducibility were evaluated. Gestational age at deliveries was followed, and cervical shear wave elasticity between term and preterm group was compared.
A total of 158 pregnant women were enrolled in this study while 120 pregnancies data were collected for subsequent analysis, 10 pregnancies spontaneously delivered during the preterm period and 110 pregnancies delivered at term. Intraobserver and interobserver reproducibility were high; however, cervical shear wave elasticity in both groups were not significantly different (external anterior lip 2.29 ± 0.66 and 2.45 ± 0.58 m/s, P value 0.30, internal anterior lip 2.74 ± 0.96 and 2.80 ± 0.61 m/s, P value 0.83). Nonsignificant correlations of cervical shear wave elasticity with gestational age and cervical length (r = -0.1 and r = 0.02, respectively) were demonstrated.
Cervical shear wave elasticity in preterm and term groups was not significantly different when measured at 18-24 weeks of gestation. There are nonsignificant correlations between cervical shear wave elasticity, gestational age and cervical length. Cervical shear wave elastography alone should not be used as a predictor for preterm delivery.
本研究旨在比较足月分娩组和早产组的宫颈剪切波弹性。
对158例妊娠18 - 24周连续前来进行孕中期超声检查的孕妇进行前瞻性队列研究。采用经阴道超声测量宫颈长度以及五个感兴趣区域的宫颈弹性。评估观察者内和观察者间的可重复性。随访分娩时的孕周,并比较足月组和早产组的宫颈剪切波弹性。
本研究共纳入158例孕妇,收集了120例妊娠数据用于后续分析,其中10例妊娠早产,110例妊娠足月分娩。观察者内和观察者间的可重复性较高;然而,两组的宫颈剪切波弹性无显著差异(外前唇分别为2.29±0.66和2.45±0.58 m/s,P值0.30;内前唇分别为2.74±0.96和2.80±0.61 m/s,P值0.83)。宫颈剪切波弹性与孕周和宫颈长度无显著相关性(r分别为 - 0.1和0.02)。
妊娠18 - 24周时测量,早产组和足月组的宫颈剪切波弹性无显著差异。宫颈剪切波弹性与孕周和宫颈长度无显著相关性。单纯的宫颈剪切波弹性成像不应作为早产的预测指标。