{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:13:41Z","timestamp":1787015621052,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81571687"],"award-info":[{"award-number":["81571687"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81701459"],"award-info":[{"award-number":["81701459"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess the reproducibility of a semiautomatic quantification tool for cervical stiffness and evaluate the normal changes in cervical elasticity during the three trimesters of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal prospective pilot study evaluated cervical elasticity during the three trimesters of pregnancy (11\u201314, 20\u201324 and 28\u201332\u2009weeks) in women with singleton pregnancies. Women with a history of conization, cerclage, cervical Naboth cysts (diameter\u2009&gt;\u200910\u2009mm), cervical tumors, or uterine malformation were excluded. A semiautomatic tool was used to evaluate the stiffness of the whole cervix and the internal and external cervical os with multiple quantitative elasticity parameters and the cervical length (CL) on the sagittal view via transvaginal elastography. Intraclass correlation coefficients (ICC) and Bland\u2013Altman analysis were used to assess intra\u2010 and interobserver variability. E\u2010Cervix parameters during the three trimesters were compared using the Friedman test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 217 women with 651 strain examinations during the three trimesters were included. The intra\u2010 and interobserver ICC for the E\u2010Cervix parameters ranged from 0.947 to 0.991 and 0.855 to 0.989, respectively. There were significant differences in all parameters among the three trimesters. Cervical elasticity showed significant softening and became heterogeneous during the three trimesters. The median CL was significantly shorter in the first trimester than in the second and third trimesters (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.004,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>E\u2010Cervix provides a graphical tool for operators to easily define regions of interest and obtain multiple repeatable measures of elasticity. The normal references for E\u2010Cervix parameters during the three trimesters reflect the physiological cervical changes during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.14170","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T03:43:16Z","timestamp":1575862996000},"page":"237-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Quantitative elastography of cervical stiffness during the three trimesters of pregnancy with a semiautomatic measurement program: A longitudinal prospective pilot study"],"prefix":"10.1111","volume":"46","author":[{"given":"Liu","family":"Du","sequence":"first","affiliation":[{"name":"Department of Ultrasonic Medicine The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou 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Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Jun","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Medicine The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong\u2010Ning","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Medicine The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou 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