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

Christine Rohr Thomsen; Maria Strandbo Schmidt Jensen; Anne Katrine Leonhard; Tanja Østerlund Mortensen; Pinar Bor; Puk Sandager; Mogens Hinge; Niels Uldbjerg

doi:10.1111/aogs.14309

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

Christine Rohr Thomsen^*, Maria Strandbo Schmidt Jensen, Anne Katrine Leonhard, Tanja Østerlund Mortensen, Pinar Bor, Puk Sandager, Mogens Hinge, Niels Uldbjerg

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

5 Citationer (Scopus)

Abstract

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.

Originalsprog	Engelsk
Tidsskrift	Acta Obstetricia et Gynecologica Scandinavica
Vol/bind	101
Nummer	2
Sider (fra-til)	241-247
Antal sider	7
ISSN	0001-6349
DOI	https://doi.org/10.1111/aogs.14309
Status	Udgivet - feb. 2022

Adgang til dokumentet

10.1111/aogs.14309Licens: CC BY-NC-ND

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564675/pdf/AOGS-101-241.pdfLicens: CC BY-NC-ND

Andre filer og links

Link to publication in Scopus

Citationsformater

@article{aa103f5ed33f4bf2871ca4e5f01e202d,

title = "A force-measuring device combined with ultrasound-based elastography for assessment of the uterine cervix",

abstract = "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.",

keywords = "INDUCTION, LABOR, LENGTH, MODEL, PREGNANCY, RISK, SONOGRAPHIC MEASUREMENT, WEEKS GESTATION, cervical dilatation time, cervical elastography index, cervical softening, cervical strength index, elastography, force-measuring device, labor induction, uterine cervix",

author = "Thomsen, {Christine Rohr} and Jensen, {Maria Strandbo Schmidt} and Leonhard, {Anne Katrine} and Mortensen, {Tanja {\O}sterlund} and Pinar Bor and Puk Sandager and Mogens Hinge and Niels Uldbjerg",

year = "2022",

month = feb,

doi = "10.1111/aogs.14309",

language = "English",

volume = "101",

pages = "241--247",

journal = "Acta Obstetricia et Gynecologica Scandinavica",

issn = "0001-6349",

publisher = "JohnWiley & Sons Ltd.",

number = "2",

}

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 et al.
I: Acta Obstetricia et Gynecologica Scandinavica, Bind 101, Nr. 2, 02.2022, s. 241-247.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - A force-measuring device combined with ultrasound-based elastography for assessment of the uterine cervix

AU - Thomsen, Christine Rohr

AU - Jensen, Maria Strandbo Schmidt

AU - Leonhard, Anne Katrine

AU - Mortensen, Tanja Østerlund

AU - Bor, Pinar

AU - Sandager, Puk

AU - Hinge, Mogens

AU - Uldbjerg, Niels

PY - 2022/2

Y1 - 2022/2

N2 - 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.

AB - 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.

KW - INDUCTION

KW - LABOR

KW - LENGTH

KW - MODEL

KW - PREGNANCY

KW - RISK

KW - SONOGRAPHIC MEASUREMENT

KW - WEEKS GESTATION

KW - cervical dilatation time

KW - cervical elastography index

KW - cervical softening

KW - cervical strength index

KW - elastography

KW - force-measuring device

KW - labor induction

KW - uterine cervix

UR - http://www.scopus.com/inward/record.url?scp=85123062502&partnerID=8YFLogxK

U2 - 10.1111/aogs.14309

DO - 10.1111/aogs.14309

M3 - Journal article

C2 - 35049047

AN - SCOPUS:85123062502

SN - 0001-6349

VL - 101

SP - 241

EP - 247

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 2

ER -

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

Abstract

Adgang til dokumentet

Andre filer og links

Fingeraftryk

Citationsformater