Preliminary Results on the Preinduction Cervix Status by Shear Wave Elastography

Abstract

The mechanical status of the cervix is a key physiological element during pregnancy. By considering a successful induction when the active phase of labor is achieved, mapping the mechanical properties of the cervix could have predictive potential for the management of induction protocols. In this sense, we performed a preliminary assessment of the diagnostic value of using shear wave elastography before labor induction in 54 women, considering the pregnancy outcome and Cesarean indications. Three anatomical cervix regions and standard methods, such as cervical length and Bishop score, were compared. To study the discriminatory power of each diagnostic method, a receiver operating characteristic curve was generated. Differences were observed using the external os region and cervical length in the failure to enter the active phase group compared to the vaginal delivery group (p < 0.05). The area under the ROC curve resulted in 68.9%, 65.2% and 67.2% for external os, internal os and cervix box using elastography, respectively, compared to 69.5% for cervical length and 62.2% for Bishop score. External os elastography values have shown promise in predicting induction success. This a priori information could be used to prepare a study with a larger sample size, which would reduce the effect of any bias selection and increase the predictive power of elastography compared to other classical techniques.

Keywords

• induction of labor
• shear wave elastography
• cervix
• shear wave velocity