Evaluation of the Combined Use of Elastography and Cervicometry With the E-Cervix Index to Predict Second Trimester Preterm Birth Risk
Bibliographic record
Abstract
Background: Preterm birth (PB) continues to be a leading cause of neonatal morbidity and mortality, with isthmic-cervical insufficiency (ICI) being among the most serious contributory factors. ICI is often a precursor for PB, and monitoring and diagnosis of this event can largely be achieved through cervicometry and elastography, especially with the use of the E-Cervix index. The aim of this study was to assess the effectiveness of integrating elastography and cervicometry, specifically the E-Cervix index, in predicting PB risk in pregnant women with ICI during the second trimester. Methods: A prospective cohort study was performed on 250 pregnant women during their second trimester, including 150 women with ICI alongside 100 control women. Cervical elastography was done to assess the stiffness of the cervix coupled with transvaginal ultrasound cervicometry to obtain the length of the cervix. The E-Cervix index was also computed to enhance the discrimination accuracy of lower predictive values. Analysis was done on Statistical Package for the Social Sciences version 27.0 and Statistical Software for Data Analysis version 17.0. Results: This study investigated the effectiveness of combining cervical elastography and cervicometry, utilizing the E-Cervix index, to assess the risk of PB in pregnant women diagnosed with ICI. The main group (n = 150) had a significantly younger mean age (30.24 ± 5.68 years) compared to the control group (32.17 ± 6.00 years, P = 0.011). Women with ICI showed shorter cervical lengths (2.6 ± 0.5 cm vs. 3.5 ± 0.4 cm, P < 0.001) and higher elasticity contrast index (6.5 ± 1.2 vs. 4.2 ± 0.9, P < 0.001). A significantly higher rate of PB (16% vs. 8%, P = 0.047) was observed in the main group. However, early diagnosis through combined elastography and cervicometry, followed by timely interventions, effectively contributed to a reduction in early PB rates, emphasizing the clinical value of integrated diagnostic approach. Conclusion: The combined use of elastography and cervicometry, particularly through the E-Cervix index, provides accurate risk assessment for preterm delivery in women with ICI. This approach demonstrates strong diagnostic performance and supports timely clinical decision-making, enhancing early intervention and improving outcomes in high-risk pregnancies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".