Study on the Predictive Value of Cervical Ultrasound Elastography Combined with Serological Markers and Cervical Bishop Score for Cervical Ripening

doi:10.12280/gjfckx.20230506

Abstract

Abstract:

Objective: To analyze the predictive value of cervical Bishop score combined with cervical ultrasound elastography and serological markers for cervical ripening. Methods: 178 pregnant women who were registered at Peking University Third Hospital from January 2022 to June 2022 and underwent induced labor were selected and divided into a successful labor induction group of 158 cases and a failed labor induction group of 20 cases. Cervical ultrasound elastography indexes, serological markers (relaxin, estradiol, estriol, progesterone), cervical Bishop score before induction of labor were collected and analyzed. Compare the differences in the above indicators between two groups, and use the receiver operator characteristic curve (ROC curve) to analyze the value of combined detection in evaluating cervical ripening. Results: The elastic contrast index (ECI), external cervical os (EOS) and relaxin levels of the failed labor induction group were lower than in the successful labor induction group, and the cervical length was longer than that in the successful labor induction group (P<0.05). There was no significant difference in the levels of progesterone, estradiol and estriol between the two groups (P>0.05). The combination of cervical Bishop score, ultrasound elastography indicators (ECI, EOS, cervical length), and serum relaxin had the highest evaluation value for cervical ripening, with an area under the ROC curve of 0.940. Conclusions: The cervical Bishop score combined with cervical ultrasound elastography and relaxin can improve the accuracy of predicting cervical ripening.

Key words: Elasticity imaging techniques, Cervical ripening, Labor, induced, Bishop score, Serological markers

LIU Yuan-ying, ZHANG Ai-qing, WANG Yong-qing. Study on the Predictive Value of Cervical Ultrasound Elastography Combined with Serological Markers and Cervical Bishop Score for Cervical Ripening[J]. Journal of International Obstetrics and Gynecology, 2024, 51(2): 184-188.

Figures/Tables 7

References 16

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组别	n	年龄（岁）	孕周（周）	孕前BMI（kg/m²）	孕次（次）
引产成功组	158	32.00（30.75，34.00）	39.71（38.71，40.57）	24.61（21.45，26.17）	1.00（1.00，2.00）
引产失败组	20	32.00（31.00，34.00）	39.50（38.71，40.43）	24.72（22.59，25.20）	1.00（1.00，2.00）
Z		-0.354	-0.030	-0.876	-1.004
P		0.723	0.976	0.381	0.315

组别	n	年龄（岁）	孕周（周）	孕前BMI（kg/m²）	孕次（次）
引产成功组	158	32.00（30.75，34.00）	39.71（38.71，40.57）	24.61（21.45，26.17）	1.00（1.00，2.00）
引产失败组	20	32.00（31.00，34.00）	39.50（38.71，40.43）	24.72（22.59，25.20）	1.00（1.00，2.00）
Z		-0.354	-0.030	-0.876	-1.004
P		0.723	0.976	0.381	0.315

组别	n	ECI	HR（%）	IOS	EOS	IOS/EOS	宫颈长度（cm）	Bishop评分（分）
引产成功组	158	4.81±0.11	46.01±1.36	0.39（0.32，0.47）	0.40（0.33，0.47）	1.01（0.85，1.12）	2.14±0.06	5.18±0.12
引产失败组	20	3.95±0.25	50.28±3.48	0.32（0.30，0.42）	0.35（0.27，0.38）	0.97（0.78，1.05）	2.85±0.12	3.60±0.23
t或Z		2.758	-1.095	-1.724	-1.964	-0.949	-3.868	4.495
P		0.006	0.275	0.085	0.049	0.343	<0.001	<0.001

组别	n	ECI	HR（%）	IOS	EOS	IOS/EOS	宫颈长度（cm）	Bishop评分（分）
引产成功组	158	4.81±0.11	46.01±1.36	0.39（0.32，0.47）	0.40（0.33，0.47）	1.01（0.85，1.12）	2.14±0.06	5.18±0.12
引产失败组	20	3.95±0.25	50.28±3.48	0.32（0.30，0.42）	0.35（0.27，0.38）	0.97（0.78，1.05）	2.85±0.12	3.60±0.23
t或Z		2.758	-1.095	-1.724	-1.964	-0.949	-3.868	4.495
P		0.006	0.275	0.085	0.049	0.343	<0.001	<0.001

组别	n	松弛素（pg/mL）	雌二醇（pg/mL）	雌三醇（pg/mL）	孕酮（ng/mL）
引产成功组	158	69.45（35.57，141.71）	8 210（6 540，9 100）	3 020（2 090，4 100）	338.05（281.10，352.27）
引产失败组	20	16.25（16.22，49.51）	8 820（4 990，9 820）	2 770（2 700，4 360）	324.16（266.12，402.38）
Z		-3.724	-0.018	-0.562	-0.175
P		<0.001	0.985	0.574	0.861