Cervical Stiffness Index as predictor of preterm birth in women with threatened preterm labor
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Objective
To evaluate the accuracy of Cervical Stiffness Index (CSI) in predicting preterm birth (PTB) in women with threatened preterm labor (PTL).
Study design
This was a single-center, prospective, observational study of women with singleton pregnancies presenting to obstetrics triage for threatened PTL between 24 0/7 and 33 6/7 weeks. Women included in the study received a physical examination, ultrasound examination, transvaginal ultrasound cervical length measurement, and cervical stiffness assessment.
Results
Between April 2022 and August 2024, 100 women with signs and symptoms of PTL were recruited. Thirty-five had a PTB, of which 7 delivered < 34 weeks, 5 within 14 days and 11 within 28 days from measurement. Median CSI and cervical length (CL) were significantly different between women delivering at term and women with a PTB. The Area under the Curve of CSI and CL for prediction of delivery ≤ 14 days from measurement were 0.979 (95% CI, 0.952–1.000) and 0.744 (0.369–1.000), respectively; for delivery ≤ 28 days from measurement, 0.802 (0.612–0.993), and 0.764 (0.579–0.948), respectively; for PTB < 34 weeks, 0.873 (0.729–1.000) and 0.836 (0.563–1.000), respectively; and for PTB < 37 weeks 0.845 (0.763–0.926) and 0.779 (0.680– 0.877), respectively.
Conclusions
Women presenting with threatened PTL and ultimately delivering prematurely have a significantly softer cervix than women delivering at term, showing the potential of Cervical Stiffness Index as a predictor of PTB in symptomatic women.
Clinical trial registration
NCT05355649
