Zhou Yimin, Jin Neng, Chen Qinqing, Lv Min, Jiang Ying, Chen Yuan, Xi Fangfang, Yang Mengmeng, Zhao Baihui, Huang Hefeng, Luo Qiong
Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China.
International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
J Int Med Res. 2021 Feb;49(2):300060520985338. doi: 10.1177/0300060520985338.
This study aimed to examine whether addition of cervical elastographic parameters measured by ElastoScan for the cervix (E-cervix) improves the predictive value of cervical length (CL) in induction of labor at term by dinoprostone.
We conducted a prospective, observational study between January 2020 and June 2020 in term primiparous women (n = 73) who were scheduled for labor induction by a 10-mg dinoprostone vaginal insert. The time intervals from the start of labor induction to regular uterine contractions and to vaginal delivery were calculated as the primary outcomes. We divided subjects into two groups using a threshold of 24 hours. Ultrasound measurements were compared between the two groups and the area under the curve (AUC) of the prediction model was calculated.
Women who delivered vaginally within 24 hours had a shorter CL and softer cervix than those who delivered after 24 hours. The combination of CL and elastographic parameters increased the AUC to 0.672 compared with CL alone (AUC = 0.637).
Measurement by E-cervix is relatively reproducible. Addition of cervical strain elastography slightly improves the predictive performance of CL in vaginal delivery within 24 hours. This technique is a promising ancillary tool for use with ultrasound.
本研究旨在探讨通过宫颈弹性成像（E-宫颈）测量的宫颈弹性参数是否能提高宫颈长度（CL）对足月使用地诺前列酮引产的预测价值。
我们在2020年1月至2020年6月期间对73名单胎初产妇进行了一项前瞻性观察研究，这些产妇计划通过阴道置入10毫克地诺前列酮进行引产。从引产开始到规律宫缩和阴道分娩的时间间隔作为主要结局指标。我们以24小时为界将受试者分为两组。比较两组的超声测量结果，并计算预测模型的曲线下面积（AUC）。
在24小时内阴道分娩的女性宫颈长度比24小时后分娩的女性短，宫颈更软。与单独使用宫颈长度相比，宫颈长度和弹性成像参数的组合使曲线下面积增加到0.672（单独宫颈长度的曲线下面积 = 0.637）。
E-宫颈测量具有相对可重复性。增加宫颈应变弹性成像可略微提高宫颈长度对24小时内阴道分娩的预测性能。该技术是一种很有前景的超声辅助工具。
