Cervical Stiffness Measured by the Cervisense Intravaginal Probe for Identification of Imminent Delivery in Symptomatic Threatened Preterm Labor.
Por:
Samper-Girona A, Aiartzaguena A, Burgos J, Muñoz-González MD, Gil MM, Valladolid A, Urones A, Cobo-Cobo T, Ferrero-Martinez SI, Goya M, Del Barco Martínez E, Blanco-Carnero JE, Prats Rodríguez P and Molina FS
Publicada:
27 abr 2026
Ahead of Print:
27 abr 2026
Resumen:
Background and Objectives: Risk stratification in symptomatic threatened preterm labor (TPTL) remains challenging, particularly for clinically actionable time horizons. We evaluated whether quantitative cervical stiffness measured with the Cervisense Intravaginal Probe discriminates between women who will and will not deliver within 7, 10, or 14 days after presentation and assessed its discriminative performance alone and in combination with transvaginal cervical length. Materials and Methods: We conducted a multicenter, non-interventional study across 10 obstetric emergency units in Spain. Eligible participants were women aged = 18 years with a live singleton pregnancy at 28(+0) to 36(+6) weeks, regular uterine contractions, intact membranes, and cervical dilatation < 2 cm on speculum examination. Cervical stiffness was measured at presentation using torsional wave elastography with the Cervisense Intravaginal Probe. Cervical length was measured by transvaginal ultrasonography following international standards. Outcomes were delivery within 7, 10, and 14 days after presentation. Discrimination was quantified using the area under the receiver operating characteristic curve (AUC). An explanatory multivariable logistic regression model for delivery within 14 days included cervical stiffness, cervical length, and covariates selected as potential confounders. Results: Among 305 participants, 17 (5.6%) delivered within 7 days, 19 (6.2%) within 10 days, and 24 (7.9%) within 14 days. Mean cervical stiffness was lower among women who delivered within 14 days than among those who did not (8.63 vs. 14.82 kPa; p = 0.048). Cervical length was shorter among women who delivered within 7, 10, and 14 days (all p < 0.001). Discrimination for cervical stiffness was moderate (AUC, 0.66, 0.64, and 0.73 for =7, =10, and =14 days) and higher for cervical length (AUC, 0.80, 0.77, and 0.78). The combined model achieved the highest discrimination (AUC, 0.85, 0.85, and 0.86). In the =14-day explanatory model, higher log-transformed cervical stiffness was associated with lower odds of delivery (OR, 0.907; 95% CI, 0.828 to 0.995; p = 0.039), as was longer cervical length (OR per 1 mm, 0.910; 95% CI, 0.876 to 0.946; p < 0.001). Conclusions: In symptomatic TPTL, Cervisense-derived cervical stiffness showed moderate discrimination for short-term delivery and provided complementary information to cervical length, with improved discrimination when both measures were combined. These findings support future studies developing multivariable prediction models that incorporate quantitative cervical consistency.
Filiaciones:
Samper-Girona A:
Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
Aiartzaguena A:
Hospital Universitario Cruces, 48903 Barakaldo, Spain
Burgos J:
Hospital Universitario Cruces, 48903 Barakaldo, Spain
Muñoz-González MD:
Hospital Universitario de Torrejón, 28850 Madrid, Spain
Gil MM:
Hospital Universitario de Torrejón, 28850 Madrid, Spain
School of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain
Valladolid A:
Hospital Universitario Basurto, 48013 Bilbao, Spain
Urones A:
Hospital Universitario Basurto, 48013 Bilbao, Spain
Cobo-Cobo T:
Hospital Clínic de Barcelona, 08036 Barcelona, Spain
Hospital Sant Joan de Dèu, 08950 Barcelona, Spain
Ferrero-Martinez SI:
Hospital Clínic de Barcelona, 08036 Barcelona, Spain
Hospital Sant Joan de Dèu, 08950 Barcelona, Spain
Goya M:
Hospital Universitario Vall d`Hebron, 08035 Barcelona, Spain
School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
Del Barco Martínez E:
Hospital Universitario Vall d`Hebron, 08035 Barcelona, Spain
Blanco-Carnero JE:
Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
Prats Rodríguez P:
Hospital Universitari Dexeus, 08028 Barcelona, Spain
Molina FS:
Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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