Obstet Gynecol Sci.  2013 Sep;56(5):312-319.

Three-dimensional volumetric gray-scale uterine cervix histogram prediction of days to delivery in full term pregnancy

• Kim JY
• Kim HJ
• Hahn MH
• Jeon HJ
• Cho GJ
• Hong SC
• Oh MJ

Abstract

OBJECTIVE
Our aim was to figure out whether volumetric gray-scale histogram difference between anterior and posterior cervix can indicate the extent of cervical consistency.
METHODS
We collected data of 95 patients who were appropriate for vaginal delivery with 36th to 37th weeks of gestational age from September 2010 to October 2011 in the Department of Obstetrics and Gynecology, Korea University Ansan Hospital. Patients were excluded who had one of the followings: Cesarean section, labor induction, premature rupture of membrane. Thirty-four patients were finally enrolled. The patients underwent evaluation of the cervix through Bishop score, cervical length, cervical volume, three-dimensional (3D) cervical volumetric gray-scale histogram. The interval days from the cervix evaluation to the delivery day were counted. We compared to 3D cervical volumetric gray-scale histogram, Bishop score, cervical length, cervical volume with interval days from the evaluation of the cervix to the delivery.
RESULTS
Gray-scale histogram difference between anterior and posterior cervix was significantly correlated to days to delivery. Its correlation coefficient (R) was 0.500 (P = 0.003). The cervical length was significantly related to the days to delivery. The correlation coefficient (R) and P-value between them were 0.421 and 0.013. However, anterior lip histogram, posterior lip histogram, total cervical volume, Bishop score were not associated with days to delivery (P >0.05).
CONCLUSION
By using gray-scale histogram difference between anterior and posterior cervix and cervical length correlated with the days to delivery. These methods can be utilized to better help predict a cervical consistency.

Keyword

Prediction of delivery day; Three-dimensional ultrasoundgraphy; Three-dimensional volumetric gray-scale histogram

MeSH Terms

Cervix Uteri
Cesarean Section
Female
Gestational Age
Gynecology
Humans
Korea
Lip
Lipids
Membranes
Obstetrics
Pregnancy
Quaternary Ammonium Compounds
Rupture
Lipids
Quaternary Ammonium Compounds

Figure

• 

  Fig. 1 Six contours of the cervix in 30° increments of rotation with a roller ball cursor. Six anterior cervix contours in 30° rotation increments.

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  Fig. 2 Three-dimensional ultrasound cervical volume measurement. (A) Multiplanar display of the anterior cervical lip: longitudinal plane in the upper left quadrant, transverse plane in the upper right quadrant and coronal plane in the lower left quadrant. The resultant threedimensional model of the anterior cervix can be seen in the lower right image. (B) Gray-level histogram of each of the lips of the cervix shown at higher magnification. The mean gray-scale histogram was calculated as 32.0, which roughly agreed with the peak gray-level on the histogram. The mean gray-scale histogram represents the echogenicity of the region of interest.

• 

  Fig. 3 Correlations between the cervical length and differences of the anterior and posterior cervix with days to delivery using a three-dimensional gray-scale histogram. (A) Cervical length and days to delivery (R = +0.38, P= 0.02, Y=2.931 [x]+6.700). (B) Anterior-posterior histogram difference and delivery day (R = +0.40, P=0.01, Y=0.183 [x]+13.890).

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