In-vivo assessment of the biomechanical properties of the uterine cervix in pregnancy
Mazza, Edoardo × Parra-Saavedra, Miguel Bajka, Michael Gratacos, Eduard Nicolaides, Kypros Deprest, Jan #
John Wiley & Sons
Prenatal Diagnosis vol:34 issue:1 pages:33-41
Measuring the stiffness of the cervix might be useful in the prediction of preterm delivery or successful induction of labour. For that purpose a variety of methods for quantitative determination of physical properties of the pregnant cervix have been developed. Herein we review studies on the clinical application of these new techniques. They are based on the quantification of mechanical, optical, or electrical properties associated with increased hydration and loss of organization in collagen structure. Quasi-static elastography determines relative values of stiffness hence it can identify differences in deformability. Quasi-static elastography unfortunately cannot quantify in absolute terms the stiffness of the cervix. Also, the current clinical studies did not demonstrate the ability to predict the time point of delivery. In contrast, measurement of maximum deformability of the cervix (e.g. quantified with the cervical consistency index, CCI) provided meaningful results, showing an increase in compliance with gestational age. These findings are consistent with aspiration measurements on the pregnant ectocervix indicating a progressive decrease of stiffness along gestation. CCI and aspiration measurements therefore represent promising techniques for quantitative assessment of the biomechanical properties of the cervix. This article is protected by copyright. All rights reserved.