Debring Bianca, Möllers Mareike, Köster Helen A, Kwiecien Robert, Braun Janina, Oelmeier Kathrin, Klockenbusch Walter, Schmitz Ralf
Department of Gynecology and Obstetrics, University Hospital of Münster, Münster, Germany.
Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany.
J Perinat Med. 2022 Aug 16;51(3):328-336. doi: 10.1515/jpm-2022-0166. Print 2023 Mar 28.
The aim of this study was to assess the value of cervical strain elastography and Cervical Sliding Sign (CSS) for predicting spontaneous preterm birth (sPTB).
In our case-control study we performed an elastographic assessment of the cervix in 82 cases of preterm birth (preterm group) and 451 control pregnancies (control group) between the 20th and 37th week of gestation. We divided the anterior cervical lip first into two ("Intern2", "Extern2") and into three sectors ("Intern3", "Middle3", "Extern3"). The tissue deformation pattern after local compression with an ultrasound probe was recorded. We distinguished between an irregularly distributed ("Spotting") and homogeneous pattern presentation. Additionally, the presence of a sliding of the anterior against the posterior cervical lip (positive CSS) during compression was evaluated. A logistic regression analysis and the Akaike Information Criterion (AIC) were used to estimate the probability of sPTB and to select a prediction model.
Spotting and positive CSS occurred more frequently in the preterm group compared to control group (97.8 vs. 2.2%, p<0.001; 26.8 vs. 4.2%, p<0.001; respectively). The model with the parameters week of gestation at ultrasound examination, Intern3, Middle3 and CSS was calculated as the highest quality model for predicting sPTB. The AUC (Area Under the Curve) was higher for this parameter combination compared to cervical length (CL) (0.926 vs. 0.729).
Cervical strain elastography pattern analysis may be useful for the prediction of sPTB, as the combination of Spotting analysis and CSS is superior to CL measurement alone.
本研究旨在评估宫颈应变弹性成像和宫颈滑动征（CSS）对预测自发性早产（sPTB）的价值。
在我们的病例对照研究中，我们对妊娠20至37周之间的82例早产病例（早产组）和451例对照妊娠（对照组）进行了宫颈弹性成像评估。我们首先将宫颈前唇分为两部分（“Intern2”，“Extern2”）和三个区域（“Intern3”，“Middle3”，“Extern3”）。记录用超声探头局部压迫后的组织变形模式。我们区分了不规则分布（“点状”）和均匀模式表现。此外，评估了压迫过程中宫颈前唇与后唇之间滑动的存在情况（CSS阳性）。使用逻辑回归分析和赤池信息准则（AIC）来估计sPTB的概率并选择预测模型。
与对照组相比，早产组中“点状”和CSS阳性更为常见（分别为97.8%对2.2%，p<0.001；26.8%对4.2%，p<0.001）。将超声检查时的孕周、Intern3、Middle3和CSS作为参数的模型被计算为预测sPTB的最高质量模型。与宫颈长度（CL）相比，该参数组合的曲线下面积（AUC）更高（0.926对0.729）。
宫颈应变弹性成像模式分析可能有助于预测sPTB，因为“点状”分析和CSS的组合优于单独的CL测量。
