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Quantitative Assessment of Cervical Softening During Pregnancy in the Rhesus Macaque with Shear Wave Elasticity Imaging

Overview
Journal Phys Med Biol
Publisher IOP Publishing
Date 2018 Mar 9
PMID 29517492
Citations 9
Authors
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Abstract

Abnormal parturition, e.g. pre- or post-term birth, is associated with maternal and neonatal morbidity and increased economic burden. This could potentially be prevented by accurate detection of abnormal softening of the uterine cervix. Shear wave elasticity imaging (SWEI) techniques that quantify tissue softness, such as shear wave speed (SWS) measurement, are promising for evaluation of the cervix. Still, interpretation of results can be complicated by biological variability (i.e. spatial variations of cervix stiffness, parity), as well as by experimental factors (i.e. type of transducer, posture during scanning). Here we investigated the ability of SWEI to detect cervical softening, as well as sources of SWS variability that can affect this task, in the pregnant and nonpregnant Rhesus macaque. Specifically, we evaluated SWS differences when imaging the cervix transabdominally with a typical linear array abdominal transducer, and transrectally with a prototype intracavitary linear array transducer. Linear mixed effects (LME) models were used to model SWS as a function of menstrual cycle day (in nonpregnant animals) and gestational age (in pregnant animals). Other variables included parity, shear wave direction, and cervix side (anterior versus posterior). In the nonpregnant cervix, the LME model indicated that SWS increased by 2% (95% confidence interval 0-3%) per day, starting eight days before menstruation. During pregnancy, SWS significantly decreased at a rate of 6% (95% CI 5-7%) per week (intracavitary approach) and 3% (95% CI 2-4%) per week (transabdominal approach), and interactions between the scanning approach and other fixed effects were also significant. These results suggest that, while absolute SWS values are influenced by factors such as scanning approach and SWEI implementation, these sources of variability do not compromise the sensitivity of SWEI to cervical softening. Our results also highlight the importance of standardizing SWEI approaches to improve their accuracy for cervical assessment.

Citing Articles

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Fang S, Shi L, Vink J, Feltovich H, Hall T, Myers K J Biomech Eng. 2024; 146(8).

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Three-dimensional anisotropic hyperelastic constitutive model describing the mechanical response of human and mouse cervix.

Shi L, Hu L, Lee N, Fang S, Myers K Acta Biomater. 2022; 150:277-294.

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Progesterone and its receptor signaling in cervical remodeling: Mechanisms of physiological actions and therapeutic implications.

Tripathy S, Nallasamy S, Mahendroo M J Steroid Biochem Mol Biol. 2022; 223:106137.

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Clinical application of cervical shear wave elastography in predicting the risk of preterm delivery in DCDA twin pregnancy.

Sun J, Li N, Jian W, Cao D, Yang J, Chen M BMC Pregnancy Childbirth. 2022; 22(1):202.

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Shear wave dispersion as a potential biomarker for cervical remodeling during pregnancy: evidence from a non-human primate model.

Torres A, Palmeri M, Feltovich H, Hall T, Rosado-Mendez I Front Phys. 2021; 8.

PMID: 34178971 PMC: 8225254. DOI: 10.3389/fphy.2020.606664.


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