{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T14:35:55Z","timestamp":1776177355224,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,7,4]],"date-time":"2020-07-04T00:00:00Z","timestamp":1593820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To investigate changes in first trimester cervical elastography, cervical length and endocervical canal width in pregnant women with a history of cervical insufficiency, and further discuss the possibility of using these markers as predictors of cervical insufficiency in early pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was an observational ultrasound study of first trimester cervical changes in singleton pregnancies between January 2016 and June 2018. Cervical elastography, cervical length and endocervical canal width were measured during the first trimester. Strain elastography was used to estimate the softness of anterior and posterior cervical lips and was expressed as percentages (strain rate).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 339 pregnant women enrolled, 24 had a history of cervical insufficiency. The anterior cervical lip was significantly softer in the cervical insufficiency group (strain rate: 0.19%\u00a0\u00b1\u00a00.05% vs 0.11%\u00a0\u00b1\u00a00.04%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Cervical length was significantly shorter in the cervical insufficiency group (36.3\u00a0\u00b1\u00a04.8\u00a0mm vs 38.3\u00a0\u00b1\u00a03.8\u00a0mm; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.014). Endocervical canal width was significantly wider in the cervical insufficiency group (5.7\u00a0\u00b1\u00a01.1\u00a0mm vs 5.2\u00a0\u00b1\u00a00.7\u00a0mm; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). Receiver operating characteristic curve analyses revealed that the optimal cut\u2010off values of anterior cervical lip, cervical length and endocervical canal width to confirm the diagnosis of cervical insufficiency were 0.15%, 35.5\u00a0mm and 5.75\u00a0mm, respectively. In multivariate logistic regression analysis, significant differences were still observed in anterior cervical strain rate (adjusted odds ratio [OR] 53.78, 95% [confidence interval [CI] 11\u2010270; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and endocervical canal width (adjusted OR, 5.41, 95% CI,1.2\u201024.7; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.029).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>First trimester cervical elastography is a valuable tool in the assessment of women with a history of cervical insufficiency. The anterior cervical lip was significantly softer in women with a history of cervical insufficiency, and the sensitivity and specificity of anterior cervical lip strain were better than that of cervical length and endocervical canal width.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13942","type":"journal-article","created":{"date-parts":[[2020,6,21]],"date-time":"2020-06-21T11:13:58Z","timestamp":1592738038000},"page":"1497-1503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Assessment of the cervix in pregnant women with a history of cervical insufficiency during the first trimester using elastography"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4519-8391","authenticated-orcid":false,"given":"Chen\u2010Yu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Medicine Mackay Medical College New Taipei City Taipei Taiwan"},{"name":"Department of 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