{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T02:29:39Z","timestamp":1773455379572,"version":"3.50.1"},"reference-count":72,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Preterm birth (PTB) accounts for two\u2010thirds of deaths of structurally normal babies and is associated with substantial lifetime healthcare costs. Prevention of PTB remains limited by the modest accuracy of prediction methods, namely transvaginal ultrasound (TVS) cervical length (CL) measurement and quantitative cervicovaginal fetal fibronectin (FFN) estimation. We report the first substantive study detailing the predictive performance of a cervical probe device based on electrical impedance spectroscopy (EIS) for PTB\u00a0\u2013\u00a0the EleCtriCaL Impedance Prediction of Preterm birth by spectroscopy of the cervix (ECCLIPPx) study. We aimed to compare the accuracy of cervical EIS\u2010based prediction of spontaneous PTB with that of prediction using TVS\u2010CL and FFN in asymptomatic women in the mid\u2010trimester.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied asymptomatic women with a singleton pregnancy at 20\u201322\u2009weeks' and 26\u201328\u2009weeks' gestation. EIS was performed using a Sheffield Mark 5.0 device that makes measurements in the frequency range 76\u2009Hz to 625\u2009kHz using a small probe housing tetrapolar electrodes. TVS\u2010CL and FFN were also measured. The associations of cervical EIS, TVS\u2010CL and FFN with spontaneous delivery before 37\u2009weeks and before 32\u2009weeks were determined by multivariate linear and non\u2010linear logistic regression analysis. Areas under the receiver\u2010operating\u2010characteristics curves (AUC) plots of sensitivity against specificity were used to compare the predictive performance of all parameters, both in isolation and in combination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 365 asymptomatic women studied at 20\u201322\u2009weeks who were not receiving treatment, 29 had spontaneous PTB, 14 had indicated PTB and 322 had term birth. At the higher frequencies assessed, cervical EIS predicted spontaneous PTB before 37\u2009weeks with an AUC of 0.76 (95%\u2009CI, 0.71\u20130.81), compared with AUCs of 0.72 (95%\u2009CI, 0.66\u20130.76) for TVS\u2010CL and 0.62 (95%\u2009CI, 0.56\u20130.72) for FFN. Combining all three assessments improved the prediction of spontaneous PTB before 37\u2009weeks (AUC, 0.79 (95%\u2009CI, 0.74\u20130.83)) compared with TVS\u2010CL and FFN alone. Incorporating a history of spontaneous PTB (defined as previous mid\u2010trimester miscarriage or spontaneous PTB (14 to &lt;\u200937\u2009weeks)) into the cervical EIS prediction model improved the accuracy of prediction of spontaneous PTB before 37\u2009weeks (AUC, 0.83 (95%\u2009CI, 0.78\u20130.87)) and before 32\u2009weeks (AUC, 0.86 (95%\u2009CI, 0.82\u20130.90)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mid\u2010trimester cervical EIS assessment predicts spontaneous PTB. Larger confirmatory studies investigating its potential clinical utility and to inform effective preventive interventions are required. \u00a9 2020 The Authors. Ultrasound in Obstetrics &amp; Gynecology published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22180","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T08:58:03Z","timestamp":1597481883000},"page":"293-302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Value of cervical electrical impedance spectroscopy to predict spontaneous preterm delivery in asymptomatic women: the <scp>ECCLIPPx<\/scp> prospective cohort study"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2502-3033","authenticated-orcid":false,"given":"D. O. 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