{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:34:57Z","timestamp":1767969297331,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T00:00:00Z","timestamp":1435795200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R21HD063031"],"award-info":[{"award-number":["R21HD063031"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Intermountain Research and Education Foundation"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the feasibility of using shear wave speed (<jats:styled-content style=\"fixed-case\">SWS<\/jats:styled-content>) estimates to detect differences in cervical softening pre\u2010 and post\u2010ripening in women undergoing induction of labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Subjects at 37\u201341 weeks' gestation undergoing cervical ripening before induction of labor were recruited (<jats:italic>n<\/jats:italic>\u2009=\u200920). Examinations, performed prior to administration of misoprostol and 4\u2009h later included Bishop score, transvaginal ultrasound measurement of cervical length, and 10 replicate <jats:styled-content style=\"fixed-case\">SWS<\/jats:styled-content> measurements using an ultrasound system equipped with a prototype transducer (128 element, 3\u2009mm diameter, 14\u2009mm aperture) attached to the clinician's hand. Subjects were divided into two groups, \u2018not\u2010in\u2010labor\u2019 and \u2018marked\u2010progression\u2019, based on cervical evaluation at the second examination. Measurements were compared via individual paired hypotheses tests and using a linear mixed model, with the latter also used to compare groups. Spearman's rank correlation coefficient was used to compare <jats:styled-content style=\"fixed-case\">SWS<\/jats:styled-content> with Bishop score. The linear mixed model can take into account clustered data and accommodate multiple predictors simultaneously.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Wilcoxon signed\u2010rank paired test established a significant difference in pre\u2010 and post\u2010ripening <jats:styled-content style=\"fixed-case\">SWS<\/jats:styled-content>, with mean <jats:styled-content style=\"fixed-case\">SWS<\/jats:styled-content> estimates of 2.53\u2009\u00b1\u20090.75 and 1.54\u2009\u00b1\u20090.31\u2009m\/s, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) in the not\u2010in\u2010labor group (decrease in stiffness) and 1.58\u2009\u00b1\u20090.33 and 2.35\u2009\u00b1\u20090.65\u2009m\/s for the marked\u2010progression group (increase in stiffness). The linear mixed model corroborated significant differences in pre\u2010 and post\u2010ripening measurements in individual subjects (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) as well as between groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). <jats:styled-content style=\"fixed-case\">SWS<\/jats:styled-content> estimates were significantly correlated with digitally\u2010assessed cervical softness and marginally correlated with Bishop score as assessed by Spearman's rank correlation coefficient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>In\u2010vivo<\/jats:italic> <jats:styled-content style=\"fixed-case\">SWS<\/jats:styled-content> estimates detected stiffness differences before and after misoprostol\u2010induced softening in term pregnancies. This ultrasonic shear elasticity imaging technique shows promise for assessing cervical softness. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14663","type":"journal-article","created":{"date-parts":[[2014,9,8]],"date-time":"2014-09-08T15:49:17Z","timestamp":1410191357000},"page":"93-98","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Changes in shear wave speed pre\u2010 and post\u2010induction of labor: a feasibility study"],"prefix":"10.1002","volume":"46","author":[{"given":"L. C.","family":"Carlson","sequence":"first","affiliation":[{"name":"Medical Physics Department University of Wisconsin  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. T.","family":"Romero","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Intermountain Healthcare  Murray UT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. L.","family":"Palmeri","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Department Duke University  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Mu\u00f1oz del Rio","sequence":"additional","affiliation":[{"name":"Medical Physics Department University of Wisconsin  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. M.","family":"Esplin","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Intermountain Healthcare  Murray UT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. M.","family":"Rotemberg","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Department Duke University  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. J.","family":"Hall","sequence":"additional","affiliation":[{"name":"Medical Physics Department University of Wisconsin  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Feltovich","sequence":"additional","affiliation":[{"name":"Medical Physics Department University of Wisconsin  Madison WI USA"},{"name":"Maternal Fetal Medicine Department Intermountain Healthcare  Provo UT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.09.013"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-8266(98)00042-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.3381184"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1095\/biolreprod.102.012443"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1095\/biolreprod.102.012534"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0174-173X(88)80022-0"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-198303000-00005"},{"key":"e_1_2_6_10_1","first-page":"753","article-title":"The effects of nonselectgive PGE2 receptor agonists on cervical tensile strength and cervical collagen content and structure","volume":"92","author":"Feltovich H","year":"2006","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-200609000-00015"},{"key":"e_1_2_6_12_1","first-page":"266","article-title":"Pelvic scoring for elective induction","volume":"24","author":"Bishop EH","year":"1964","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1331024"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7315"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.573831"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.05.015"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9021"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11067"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12344"},{"key":"e_1_2_6_20_1","first-page":"1","article-title":"Reliability of quantitative elastography of the uterine cervix in at\u2010term pregnancies","volume":"7","author":"Fruscalzo A","year":"2013","journal-title":"J Perinat Med"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12383"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(98)00110-0"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.12.019"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2013.04.027"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1109\/TUFFC.2009.1006"},{"key":"e_1_2_6_26_1","first-page":"728","article-title":"Acoustic radiation force impulse imaging of in vivo breast masses","volume":"1","author":"Sharma AC","year":"2004","journal-title":"IEEE Ultrason Symp"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2010.01.011"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12555"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1109\/TUFFC.2006.1642509"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2010.02.007"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1109\/TUFFC.2014.006360"}],"container-title":["Ultrasound in Obstetrics &amp; 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