The Efficiency of E-Cervix Cervical Elastic Parameters of Second Trimester Ultrasound Combined with Cervical Anterior Angle for Predicting Spontaneous Preterm Birth

HE Liu; JIA Yang; LU Huiling; ZHANG Li; WU Dan

doi:10.3639/i.issn.2095-3097.2025.02.006

Abstract：Objective To explore and analyze the efficacy of integrating E-Cervix cervical elastic parameters with anterior cervical angle in forecasting spontaneous preterm labor in the second trimester.Methods 88 pregnant women who underwent prenatal check-ups at Baoji Central Hospital from June 2022 to December 2023 were selected as the research subjects.General data of the subjects were collected,and pregnancy outcomes were tracked.The 88 pregnant women were divided into two subgroups based on whether spontaneous preterm birth occurred:full-term group(n=67)and preterm group(n=21).All pregnant women underwent E-Cervix cervical elastography ultrasound examination and cervical anterior angle ultrasound examination at 16-28 weeks of pregnancy.The two groups were compared in terms of general information,ultrasound E-Cervix cervical elasticity parameters,and cervical anterior angle.Using receiver operating characteristic(ROC)curves to analyze the predictive value of ultrasound E-Cervix cervical elasticity parameters combined with cervical anterior angle for spontaneous preterm birth;using multiple Logistic regression analysis to explore the influencing factors of spontaneous preterm birth in pregnant women.Results There was no statistically significant difference in the E-Cervix cervical elasticity parameter EOS between the two groups(P＞0.05).In the premature delivery group,the E-Cervix cervical elasticity parameters ECI,IOS,IOS/EOS,and cervical anterior angle were higher than those in the full-term group,while the HR was lower than that in the full-term group(all P＜0.05).The AUC values for predicting spontaneous preterm birth using ECI,HR,cervical anterior angle,and their combination were 0.693(95％CI:0.648-0.738),0.841(95％CI:0.796-0.891),0.768(95％CI:0.726-0.818),and 0.947(95％CI:0.902-0.992),respectively.The proportion of the preterm group with pregnancy hypertension,pregnancy diabetes,anemia during pregnancy,and cervical incompetence was significantly higher than that of the term group,and the length of the closed cervical canal was shorter than that of the term group(P＜0.05).There were 4 patients with cervical incompetence in the preterm group,of whom 2 had cervical cerclage,2 had no cerclage,and all 4 had preterm delivery.Multivariate analysis showed that the length of the closed cervical canal(OR=1.960),pregnancy-induced hypertension(OR=1.694),pregnancy-induced diabetes(OR=2.044),cervical incompetence(OR=1.866),IOS(OR=2.765),HR(OR=3.124),and anterior cervical angle(OR=3.522)were the influencing factors of spontaneous preterm delivery(P＜0.05).Conclusion The E-Cervix cervical elastic parameters and anterior cervical angle of ultrasound in the second trimester can serve as significant indicators for predicting spontaneous preterm birth,and their combined application is more effective.