A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18-24 weeks is associated with a higher prevalence of spontaneous preterm delivery

• Main Authors: Edgar Hernandez-Andrade, Eli Maymon, Suchaya Luewan, Gaurav Bhatti, Mohammad Mehrmohammadi, Offer Erez, Percy Pacora, Bogdan Done, Sonia S. Hassan, Roberto Romero
• Format: Journal
• Published: 2018
• Subjects: Medicine
• Online Access: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85048090331&origin=inward; http://cmuir.cmu.ac.th/jspui/handle/6653943832/58866
• Institution: Chiang Mai University

© 2018 2018 Walter de Gruyter GmbH, Berlin/Boston. To determine whether a soft cervix identified by shear-wave elastography between 18 and 24 weeks of gestation is associated with increased frequency of spontaneous preterm delivery (sPTD). This prospective cohort study included 628 consecutive women with a singleton pregnancy. Cervical length (mm) and softness [shear-wave speed: (SWS) meters per second (m/s)] of the internal cervical os were measured at 18-24 weeks of gestation. Frequency of sPTD <37 (sPTD<37) and <34 (sPTD<34) weeks of gestation was compared among women with and without a short (≤25 mm) and/or a soft cervix (SWS <25thpercentile). There were 31/628 (4.9%) sPTD<37 and 12/628 (1.9%) sPTD<34 deliveries. The combination of a soft and a short cervix increased the risk of sPTD<37 by 18-fold [relative risk (RR) 18.0 (95% confidence interval [CI], 7.7-43.9); P<0.0001] and the risk of sPTD<34 by 120-fold [RR 120.0 (95% CI 12.3-1009.9); P<0.0001] compared to women with normal cervical length. A soft-only cervix increased the risk of sPTD<37 by 4.5-fold [RR 4.5 (95% CI 2.1-9.8); P=0.0002] and of sPTD<34 by 21-fold [RR 21.0 (95% CI 2.6-169.3); P=0.0003] compared to a non-soft cervix. A soft cervix at 18-24 weeks of gestation increases the risk of sPTD <37 and <34 weeks of gestation independently of cervical length.