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A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix

INTRODUCTION: In this feasibility study, we hypothesize that the evaluation of cervical biomechanical strength can be improved if cervical length measurement is supplemented with quantitative elastography, which is a technique based on conventional ultrasound elastography combined with a force‐measu...

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Autores principales: Thomsen, Christine Rohr, Jensen, Maria Strandbo Schmidt, Leonhard, Anne Katrine, Mortensen, Tanja Østerlund, Bor, Pinar, Sandager, Puk, Hinge, Mogens, Uldbjerg, Niels
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564675/
https://www.ncbi.nlm.nih.gov/pubmed/35049047
http://dx.doi.org/10.1111/aogs.14309
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author Thomsen, Christine Rohr
Jensen, Maria Strandbo Schmidt
Leonhard, Anne Katrine
Mortensen, Tanja Østerlund
Bor, Pinar
Sandager, Puk
Hinge, Mogens
Uldbjerg, Niels
author_facet Thomsen, Christine Rohr
Jensen, Maria Strandbo Schmidt
Leonhard, Anne Katrine
Mortensen, Tanja Østerlund
Bor, Pinar
Sandager, Puk
Hinge, Mogens
Uldbjerg, Niels
author_sort Thomsen, Christine Rohr
collection PubMed
description INTRODUCTION: In this feasibility study, we hypothesize that the evaluation of cervical biomechanical strength can be improved if cervical length measurement is supplemented with quantitative elastography, which is a technique based on conventional ultrasound elastography combined with a force‐measuring device. Our aims were to: (a) develop a force‐measuring device; (b) introduce a cervical elastography index (CEI) and a cervical strength index (CSI; defined as cervical length × CEI); (c) evaluate how these indexes assess the cervical softening that takes place during normal pregnancy; and (d) how these indexes predict the cervical dilatation time from 4 to 10 cm. MATERIAL AND METHODS: An electronic force‐measuring device was mounted on the handle of the transvaginal probe, allowing for force measurement when conducting elastography. The study group concerned with normal cervical softening included 44 unselected pregnant women. Outcomes were CEI and CSI at different gestational ages. The study group for labor induction included 26 singleton term pregnant women admitted for labor induction. Outcome was defined as cervical dilatation time from 4 to 10 cm. Elastography measured the changes in mean gray value (intensity) during manual compressions. Region of interest was set within the anterior cervical lip. RESULTS: We found that the mean of all variables regarding cervical softening decreased from early to late pregnancy: ie cervical length from 34 to 29 mm, CEI from 0.17 to 0.11 N, and CSI from 5.9 to 3.1 N mm. Moreover, the cervical dilatation time during labor induction was associated with CEI, although not statistically significantly (area under the ROC curve of 0.67), but not with the Bishop score, the cervical length, or the CSI. CONCLUSIONS: We propose that quantitative elastography based on changes in the intensity of the B‐mode ultrasound recording, in combination with a force‐measuring device on the handle of the vaginal probe, deserves further investigation as an approach for evaluation of cervical biomechanical strength.
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spelling pubmed-95646752022-12-06 A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix Thomsen, Christine Rohr Jensen, Maria Strandbo Schmidt Leonhard, Anne Katrine Mortensen, Tanja Østerlund Bor, Pinar Sandager, Puk Hinge, Mogens Uldbjerg, Niels Acta Obstet Gynecol Scand Pregnancy INTRODUCTION: In this feasibility study, we hypothesize that the evaluation of cervical biomechanical strength can be improved if cervical length measurement is supplemented with quantitative elastography, which is a technique based on conventional ultrasound elastography combined with a force‐measuring device. Our aims were to: (a) develop a force‐measuring device; (b) introduce a cervical elastography index (CEI) and a cervical strength index (CSI; defined as cervical length × CEI); (c) evaluate how these indexes assess the cervical softening that takes place during normal pregnancy; and (d) how these indexes predict the cervical dilatation time from 4 to 10 cm. MATERIAL AND METHODS: An electronic force‐measuring device was mounted on the handle of the transvaginal probe, allowing for force measurement when conducting elastography. The study group concerned with normal cervical softening included 44 unselected pregnant women. Outcomes were CEI and CSI at different gestational ages. The study group for labor induction included 26 singleton term pregnant women admitted for labor induction. Outcome was defined as cervical dilatation time from 4 to 10 cm. Elastography measured the changes in mean gray value (intensity) during manual compressions. Region of interest was set within the anterior cervical lip. RESULTS: We found that the mean of all variables regarding cervical softening decreased from early to late pregnancy: ie cervical length from 34 to 29 mm, CEI from 0.17 to 0.11 N, and CSI from 5.9 to 3.1 N mm. Moreover, the cervical dilatation time during labor induction was associated with CEI, although not statistically significantly (area under the ROC curve of 0.67), but not with the Bishop score, the cervical length, or the CSI. CONCLUSIONS: We propose that quantitative elastography based on changes in the intensity of the B‐mode ultrasound recording, in combination with a force‐measuring device on the handle of the vaginal probe, deserves further investigation as an approach for evaluation of cervical biomechanical strength. John Wiley and Sons Inc. 2022-01-20 /pmc/articles/PMC9564675/ /pubmed/35049047 http://dx.doi.org/10.1111/aogs.14309 Text en © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Pregnancy
Thomsen, Christine Rohr
Jensen, Maria Strandbo Schmidt
Leonhard, Anne Katrine
Mortensen, Tanja Østerlund
Bor, Pinar
Sandager, Puk
Hinge, Mogens
Uldbjerg, Niels
A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix
title A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix
title_full A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix
title_fullStr A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix
title_full_unstemmed A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix
title_short A force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix
title_sort force‐measuring device combined with ultrasound‐based elastography for assessment of the uterine cervix
topic Pregnancy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564675/
https://www.ncbi.nlm.nih.gov/pubmed/35049047
http://dx.doi.org/10.1111/aogs.14309
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