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Oral Concurrent Session 9 - Fetal US Genetics

Oral Concurrent Sessions

(94) Fully quantitative operator-independent numeric cervical softening device: Cervical softening rate associated with mode of delivery

Wednesday, February 14, 2024
5:15 PM – 5:30 PM  
Location: Potomac Ballroom D, Ballroom Level
Objective: To utilize a novel, fully quantitative cervical elastography system (FQ-CES) to numerically measure cervical stiffness at term to predict mode of delivery.

Study Design: This is a prospective longitudinal cohort study of pregnant patients who underwent FQ-CES starting 37 weeks and weekly thereafter until delivery occurred. We invented FQ-CES, which modifies a transvaginal ultrasound probe to quantify both pressure applied and tissue deformation, thereby yielding a fully quantified strain-based elastography system that provides a numeric quantification (Young’s modulus) of cervical tissue stiffness.  This system is operator independent and can be compared across patients and within patients over time. Singleton pregnancies at 37 weeks awaiting spontaneous labor and vaginal delivery were enrolled and had FQ-CES measured weekly until delivery occurred. Patients remained enrolled regardless of their eventual timing or indications for delivery. Young’s modulus was log transformed to achieve normality of distribution (logYM). Cervical tissue logYM from FQ-CES and CL were analyzed over pregnancy using linear mixed effect models.

Results: A total of 122 patients were included, 109 vaginal births and 12 cesarean births. Cervical tissue stiffness (logYM) decreased from 37 weeks until delivery at a rate of 13% per week (P=0.005). In patients with eventual vaginal birth the softening rate is 15% per week (P=0.001) whereas those with cesarean birth did not soften. The trend lines for rate of softening significantly differed (P=0.02) by eventual mode of delivery.

Conclusion: FQ-CES detects different cervical softening patterns at term associated with eventual mode of delivery, which may provide opportunity to define normal and abnormal cervical remodeling ahead of birth.