Obstet Gynecol Sci.  2020 Jan;63(1):42-54. 10.5468/ogs.2020.63.1.42.

Standardization of measurement of cervical elastography, its reproducibility, and analysis of baseline clinical factors affecting elastographic parameters

  • 1Department of Obstetrics and Gynecology, Kyung Hee University School of Medicine, Seoul, Korea.
  • 2Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Obstetrics and Gynecology, Kyungpook National University Hospital, Daegu, Korea.
  • 4Department of Obstetrics and Gynecology, Graduate School of Medicine, Dongguk University, Seoul, Korea.
  • 5Department of Obstetrics and Gynecology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
  • 6Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
  • 7Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ohsymd@skku.edu


To provide a standardized protocol for the measurement of cervical strain elastography, present its reproducibility, and analyze baseline clinical factors affecting the measurement of elastographic parameters.
This study was performed by the Korean Research Group of Cervical Elastography. We enrolled pregnant women according to our study protocol. After measuring the cervical length, elastography was performed using the E-Cervixâ„¢ quantification tool to measure the strain of the cervix using intrinsic compression. We evaluated 5 elastographic parameters, namely, the strain of the internal os of the cervix (IOS), strain of the external os of the cervix (EOS), ratio of the strain of IOS and EOS, elasticity contrast index, and hardness ratio. For baseline clinical factors, we examined the maternal body mass index, blood pressure, heart rate, uterine artery Doppler indices, and fetal presentation.
We established a specific protocol for the measurement of cervical elastography using the E cervix program. For all elastographic parameters, the intra-observer intraclass correlation coefficient (ICC) ranged from 0.633 to 0.723 for single measures and from 0.838 to 0.887 for average measures, and the inter-observer ICC ranged from 0.814 to 0.977 for single measures and from 0.901 to 0.988 for average measures. Regression analysis showed that the measurement of the elastographic parameter was not affected by baseline clinical factors.
We present a standardized protocol for the measurement of cervical elastography using intrinsic compression. According to this protocol, reproducibility was acceptable and the measurement of elastographic parameters was not affected by the baseline clinical factors studied.


Cervix uteri; Elastography; Standardization; Reproducibility of results; Premature birth

MeSH Terms

Blood Pressure
Body Mass Index
Cervix Uteri
Elasticity Imaging Techniques*
Heart Rate
Labor Presentation
Pregnant Women
Premature Birth
Reproducibility of Results
Uterine Artery
Full Text Links
  • OGS
export Copy
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error