Abstract
The objective of this study was to determine whether estimates of ultrasonic attenuation
could detect changes in the cervix associated with medically induced cervical remodeling.
Thirty-six full-term pregnant women underwent two transvaginal ultrasonic examinations
separated in time by 12 h to determine cervical attenuation, cervical length and changes
thereof. Ultrasonic attenuation and cervical length data were acquired from a zone
(Zonare Medical Systems, Mountain View, CA, USA) ultrasound system using a 5–9 MHz
endovaginal probe. Cervical attenuation and cervical length significantly decreased
in the 12 h between the pre-cervical ripening time point and 12 h later. The mean
cervical attenuation was 1.1 ± 0.4 dB/cm-MHz before cervical ripening agents were
used and 0.8 ± 0.4 dB/cm-MHz 12 h later (p < 0.0001). The mean cervical length also decreased from 3.1 ± 0.9 cm before the cervical
ripening was administered to 2.0 ± 1.1 cm 12 h later (p < 0.0001). Cervical attenuation and cervical length detected changes in cervical
remodeling 12 h after cervical ripening administration.
Key Words
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References
- Ultrasonic detection of the anisotropy of protein cross linking in myocardium at diagnostic frequencies.IEEE Trans. 2007; 54: 1360-1369
- Cervical assessment by ultrasound for preventing preterm delivery.Cochrane Database Syst Rev. 2009; : CD007235
- Comparison of algorithms for estimating ultrasound attenuation when predicting cervical remodeling in a rat model.Proc 2011 IEEE Int Symp Biomed Imaging. 2011; : 883-886
- In vivo ultrasonic attenuation slope estimates for detecting cervical ripening in rats: Preliminary results.J Acoust Soc Am. 2008; 123: 1794-1800
- Impact of local attenuation approximations when estimating correlation length from backscattered ultrasound echoes.J Acoust Soc Am. 2006; 120: 546-553
- Estimation of total attenuation and scatterer size from backscattered ultrasound waveforms.J Acoust Soc Am. 2005; 117: 1431-1439
- Intracervical prostaglandins for induction of labour.Cochrane Database Syst Rev. 2008; : CD006971
- Induction of labour in nulliparous and multiparous women: A UK, multicentre, open-label study of intravaginal misoprostol in comparison with dinoprostone.BJOG. 2008; 115: 1279-1288
- Universal cervical-length screening and vaginal progesterone prevents early preterm births, reduces neonatal morbidity and is cost saving: Doing nothing is no longer an option.Ultrasound Obstet Gynecol. 2011; 38: 1-9
- Estimation of shear wave speed in the human uterine cervix.Ultrasound Obstet Gynecol. 2014; 43: 452-458
- Mifepristone-induced cervical ripening: Structural, biomechanical, and molecular events.Am J Obst Gynecol. 2006; 194: 1391-1398
- The fibrous nature of the human cervix, and its relation to the isthmic segment in gravid and nongravid uteri.Am J Obst Gynecol. 1947; 53: 541-557
- Connective tissue changes incident to cervical effacement.Am J Obstet Gynecol. 1960; 80: 939-945
- Connective tissue in human cervical ripening.in: Leppert P.C. Woessner Jr., J.F. The extracellular matrix of the uterus, cervix and fetal membranes: Synthesis, degradation and hormonal regulation. Perinatology Press, Ithaca, NY1991: 87-104
- Pre-induction of labour: Comparing dinoprostone vaginal insert to repeated prostaglandin administration. A systematic review and meta-analysis.J Mat Fetal Neo Med. 2012; 25: 1965-1969
- Quantitative imaging of the cervix: Setting the bar.Ultrasound Obstet Gynecol. 2013; 41: 121-128
- Beyond cervical length: Emerging technologies for assessing the pregnant cervix.Am J Obstet Gynecol. 2012; 207: 345-354
- Effects of selective and nonselective PGE2 receptor agonists on cervical tensile strength and collagen organization and microstructure in the pregnant rat at term.Am J Obstet Gynecol. 2005; 192: 753-760
- Quantitative ultrasound assessment of cervical microstructure.Ultrason Imaging. 2010; 32: 131-142
- Pregnancy related changes in rat cervix glycosaminoglycans.Biochem J. 1980; 192: 1-8
- High-frequency ultrasound detection of the temporal evolution of protein cross linking in myocardial tissue.IEEE Trans. 2000; 47: 1051-1058
- Delineation of the extracellular determinants of ultrasonic scattering from elastic arteries.Ultrasound Med Biol. 2000; 26: 613-620
- The extracellular matrix is an important source of ultrasound backscatter from myocardium.J Acoust Soc Am. 2000; 107: 612-619
- Anisotropy of the apparent frequency dependence of backscatter in formalin fixed human myocardium.J Acoust Soc Am. 1997; 101: 563-568
- The extensibility of the cervix uteri of the rat at different times of pregnancy.J Physiol. 1962; 160: 214-220
- The global impact of preterm birth.in: Breghella V. Preterm birth: Prevention and management. Wiley-Blackwell, Oxford, UK2010: 1-7
- Three-dimensional, extended field-of-view ultrasound method for estimating large strain mechanical properties of the cervix during pregnancy.Ultrason Imaging. 2012; 34: 1-14
- The cervix as a biomechanical structure.Ultrasound Obstet Gynecol. 2006; 28: 745-749
- Care for women with prior preterm birth.Am J Obstet Gynecol. 2010; 203: 89-100
- The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network.NEJM. 1996; 334: 567-572
- Modeling acoustic backscatter from kidney microstructure using an anisotropic correlation function.J Acoust Soc Am. 1995; 97: 649-655
- Identifying acoustic scattering sources in normal renal parenchyma in vivo by varying arterial and ureteral pressures.Ultrasound Med Biol. 1992; 18: 587-599
- Relationship between dilatation of the rat uterine cervix and a small dermatan sulfate proteoglycan.Biol Reprod. 1990; 42: 87-97
- A theoretical comparison of attenuation measurement techniques from backscattered ultrasound echoes.J Acoust Soc Am. 2011; 129: 2316-2324
- Estimate of the attenuation coefficient using a clinical array transducer for the detection of cervical ripening in human pregnancy.Ultrasonics. 2011; 51: 34-39
- Application of Fourier transform-second-harmonic generation imaging to the rat cervix.J Micro. 2013; 251: 77-83
- Global report on preterm birth and stillbirth (1 of 7): Definitions, description of the burden and opportunities to improve data.BMC Pregnancy Childbirth. 2010; 10: S1
- Anatomy and physiology of cervical ripening.Clin Obstet Gynecol. 1995; 38: 267-279
- Further evidence of a decorin-collagen interaction in the disruption of cervical collagen fibers during rat gestation.Am J Obstet Gynecol. 2000; 182: 805-811
- System-level biomechanical approach for the evaluation of term and preterm pregnancy maintenance.J Biomech Egin. 2013; 135: 021009
- Born a bit too early: Recent trends in late preterm births.NCHS Data Brief. 2009; : 1-8
- Ultrasonic attenuation estimation of the pregnant cervix: A preliminary report.Ultrasound Obstet Gynecol. 2010; 36: 218-225
- Quantitative ultrasound assessment of the rat cervix.J Ultrasound Med. 2006; 25: 1031-1040
- Relationship between collagen and ultrasonic attenuation and velocity in tissue.Proc Ultrasonics Intl. 1977; 77: 194-205
- Acoustic propagation properties of normal, stunned, and infarcted myocardium. Morphological and biochemical determinants.Circulation. 1995; 81: 154-160
- What we have learned about cervical ultrasound.Semin Perinatol. 2003; 27: 194-203
- Prediction of preterm birth using the cervical consistency index.Ultrasound Obstet Gynecol. 2011; 38: 44-51
- Mechanical and structural changes of the rat cervix in late-stage pregnancy.J Mech Behav Biomed Mater. 2013; 17: 66-75
- The preterm parturition syndrome.BJOG. 2006; 113: 17-42
- A blueprint for the prevention of preterm birth: Vaginal progesterone in women with a short cervix.J Perinat Med. 2013; 41: 27-44
- Principles of medical imaging.Academic Press, San Diego1992
- From concept to practice: the recent history of preterm delivery prevention. Part I: Cervical competence.Am J Perinatol. 2006; 23: 3-13
- From concept to practice: the recent history of preterm delivery prevention. Part II: Subclinical infection and hormonal effects.Am J Perinatol. 2006; 23: 75-84
- Endocrinology of parturition.J Clin Endocrinol Metab. 2000; 85: 4421-4425
- Identification of human myocardial infarction in vitro based on the frequency dependence of ultrasonic backscatter.J Acoust Soc Am. 1992; 91: 3018-3025
- Structural remodeling of human myocardial tissue after infarction. Quantification with ultrasonic backscatter.Circulation. 1992; 85: 259-268
- Relationship between dilatation of the rat uterine cervix and a small dermatan sulfate proteoglycan.in: Leppert P.C. Woessner Jr., J.F. The extracellular matrix of the uterus, cervix and fetal membranes: Synthesis, degradation and hormonal regulation. Perinatology Press, Ithaca, NY1991: 97-112
- Dynamics of cervical remodeling during pregnancy and parturition: mechanisms and current concepts.Semin Reprod Med. 2007; 25: 69-79
- The collagenous tissues of the cervix during pregnancy and delivery.in: Leppert P.C. Woessner Jr., J.F. The extracellular matrix of the uterus, cervix, and fetal membranes: Synthesis, degradation and hormonal regulation. Perinatology Press, Ithaca, NY1991: 68-76
Article info
Publication history
Published online: May 22, 2015
Accepted:
April 26,
2015
Received in revised form:
April 22,
2015
Received:
August 31,
2014
Identification
Copyright
© 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
