Assessing Cervical Stiffness and Cervical Length about Gestational Age: A Prospective Study Using Transvaginal Ultrasound and Shear Wave Elastography

Abstract

Preterm birth (PTB) continues to be a major contributor to neonatal health complications worldwide. While transvaginal sonography (TVS) is widely used to assess cervical length as a predictive tool for PTB, its accuracy is limited. Recently, Shear Wave Elastography (SWE) has become a potential supplementary method for evaluating cervical stiffness. This study investigates the connection between cervical length, cervical stiffness, and gestational age to determine whether stiffness serves as an independent indicator of PTB risk. The cross-sectional study was conducted over 18 months and involved 100 pregnant women in their second trimester. Cervical length was measured via TVS, while cervical stiffness was assessed at three specific cervical sites (internal os, mid-cervical canal, and external os) using SWE. Statistical analysis, including Pearson’s correlation, was performed utilizing SPSS (Version 19), with a significance level set at p<0.05.A significant negative correlation is observed between cervical length and gestational age (p<0.05). Additionally, cervical stiffness progressively declined as pregnancy advanced. Women who experienced PTB exhibited considerably shorter cervical lengths (< 25 mm) and lower cervical stiffness values compared to those who carried to term (p< 0.05). The findings suggest that SWE-based cervical stiffness assessment, together with the measurement of cervical length, enhances predictive accuracy for PTB. Integrating SWE into routine obstetric evaluation could improve early risk identification and preventive care strategies. To verify these outcomes, more thorough investigations are recommended.