Kwon Hayan, Sung Ji-Hee, Park Hyun Soo, Kwon Ja-Young, Jung Yun Ji, Seol Hyun-Joo, Kim Hyun Mi, Seong Won Joon, Hwang Han Sung, Oh Soo-Young
Department of Obstetrics and Gynecology, Yonsei University Health System, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Diagnostics (Basel). 2025 Jul 31;15(15):1934. doi: 10.3390/diagnostics15151934.
: Accurately identifying women at high risk for preterm birth among those with threatened preterm labor (PTL) is crucial for effective interventions or tocolytic management to reduce preterm birth and its complications. This study aimed to determine the predictive value of cervical elastography for preterm delivery before 37 weeks of gestation in patients with threatened PTL and a cervical length greater than 15 mm. : This prospective cohort study included pregnant women presenting with threatened PTL at between 24 and 34 weeks gestation. All participants underwent cervical elastography at diagnosis. We compared cervical elastography parameters between women who delivered spontaneously preterm (<37 weeks) and those who delivered at full term and assessed the ability of these parameters to predict spontaneous preterm delivery. : Among the 107 enrolled individuals with threatened PTL and a cervical length of ≥15 mm, 55 (42%) experienced preterm birth (<37 weeks). Internal os stiffness (IOS), internal-to-external os stiffness ratio (IOS/EOS ratio), and elasticity contrast index (ECI) were significantly associated with a risk of preterm birth compared to full-term birth. The IOS/EOS ratio was associated with 10-fold higher odds of preterm birth at <37 weeks (95% confidence interval [CI], 1.82-59.98), and ECI was associated with 1.5-fold higher odds (95% CI, 1.01-2.37). The IOS/EOS ratio demonstrated good predictive value (area under the curve (AUC) = 0.678) and the combination of CL ≤ 25 mm and the IOS/EOS ratio had good diagnostic performance for predicting preterm birth (AUC = 0.708). : Cervical elastography using the E-Cervix™ system appears to improve the ability to predict preterm birth in pregnant women with threatened PTL and a cervical length greater than 15 mm.
在有先兆早产（PTL）的女性中准确识别早产高危女性，对于采取有效干预措施或进行宫缩抑制剂治疗以减少早产及其并发症至关重要。本研究旨在确定宫颈弹性成像对有先兆PTL且宫颈长度大于15mm的患者在妊娠37周前早产的预测价值。：这项前瞻性队列研究纳入了妊娠24至34周出现先兆PTL的孕妇。所有参与者在诊断时均接受了宫颈弹性成像检查。我们比较了自发早产（<37周）的女性和足月分娩女性的宫颈弹性成像参数，并评估了这些参数预测自发早产的能力。：在107名纳入研究的有先兆PTL且宫颈长度≥15mm的个体中，55名（42%）发生了早产（<37周）。与足月分娩相比，内口硬度（IOS）、内外口硬度比（IOS/EOS比）和弹性对比指数（ECI）与早产风险显著相关。IOS/EOS比与<37周早产几率高10倍相关（95%置信区间[CI]，1.82 - 59.98），ECI与早产几率高1.5倍相关（95%CI，1.01 - 2.37）。IOS/EOS比显示出良好的预测价值（曲线下面积[AUC]=0.678），宫颈长度≤25mm和IOS/EOS比的组合对预测早产具有良好的诊断性能（AUC = 0.708）。：使用E - Cervix™系统的宫颈弹性成像似乎提高了对有先兆PTL且宫颈长度大于15mm的孕妇早产的预测能力。
