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Basic Science

Poster Session 4

(1066) Serial measurements of ultrasonic dimensions of gravid maternal anatomy and aspirated cervical stiffness

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Foundation Awardee
Objective: Reproductive tissues grow and remodel during pregnancy to accommodate the developing fetus. With little known about this process in normal human pregnancy, delineating abnormalities in preterm birth (PTB) is challenging. This study serially assessed maternal anatomy size and cervical stiffness for patients at low risk for PTB.

Study Design: This was a prospective observational study of patients at low risk for PTB. Patients (n = 47, all delivered at term) were asked to attend four research visits: late 1st (L1, 93-153 weeks), middle 2nd (M2, 173-205 weeks), late 2nd (L2, 233-271 weeks), and middle 3rd trimester (M3, 334-380 weeks). Cervical stiffness and maternal dimensions were measured via aspiration and ultrasound, respectively. The primary outcomes were linear regression slopes (accounting for patient correlation) for dimension measurements of intrauterine diameter (UD), uterine wall thickness (UT), cervical length (cm/week), and aspirated cervical stiffness (aCS, mbar/week) (fig. 1). The overall slope (all four visits) and slope between visits were found.

Results: The inferior-superior UD increased fastest between L1 and M2 (slope = 0.80 cm/week). The anterior-posterior UD increased fastest between L2 and M3 (slope = 0.26 cm/week) and left-right UD between M2 and L2 (slope = 0.86 cm/week). The fundal and left/right UT increased during pregnancy (slope = 0.01 and 0.02 cm/week, respectively), whereas the lower uterine thinned (slope = -0.02 cm/week). No significant slope value was found for the anterior UT. The cervical length decreased (slope = -0.04 cm/week), with the largest rate of decrease between L2 and M3 (slope = -0.06 cm/week). aCS decreased as pregnancy progressed (slope = -3 mbar/week), with the largest decrease between L1 to M2 (slope = -5 mbar/week).

Conclusion: This novel dataset shows the rate of lower uterine segment thinning, cervical length shortening, and decreases in cervical stiffness are gestational age-dependent. These data is vital to further developing computational models to understand how the uterus and cervix function in normal and abnormal pregnancies leading to PTB.

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