Using shear wave elastography to assess uterine tonicity after vaginal delivery

Abstract This study aims to evaluate the feasibility and clinical interest of shear wave elastography, by quantitatively estimating the baseline stiffness of the myometrium before and after placental expulsion. We conducted a prospective cohort study of women at term, without known risk factors for...

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Autores principales:	Joanna Sichitiu, Jean-Yves Meuwly, David Baud, David Desseauve
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9fb6945fa7604d1a86f4006c7de36785
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spelling	oai:doaj.org-article:9fb6945fa7604d1a86f4006c7de367852021-12-02T15:45:31ZUsing shear wave elastography to assess uterine tonicity after vaginal delivery10.1038/s41598-021-89756-62045-2322https://doaj.org/article/9fb6945fa7604d1a86f4006c7de367852021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89756-6https://doaj.org/toc/2045-2322Abstract This study aims to evaluate the feasibility and clinical interest of shear wave elastography, by quantitatively estimating the baseline stiffness of the myometrium before and after placental expulsion. We conducted a prospective cohort study of women at term, without known risk factors for postpartum hemorrhage, who gave birth via spontaneous labor in our tertiary center. Myometrium tonicity was evaluated based on measurements of shear wave speed (SWS) in the anterior uterine corpus. All data points were collected by a single operator. Measurements were carried out at three different time points: after fetal delivery (T1), after placental delivery (T2) and 30 min after placental delivery (T3). Our primary objective was to assess the feasibility of this new imaging technique. Ten valid SWS measurements obtained at each of the three different time points were considered as a positive primary outcome. Our secondary objectives were to evaluate the difference in median myometrial shear wave velocity between each time point, as well as to determine the correlation between myometrial shear wave velocity and patients’ characteristics. 38 women were recruited during the study period, of whom 34 met the study criteria. 1017 SWS measurements were obtained. The median time to perform measurements was 16 s for one value, and 2 min 56 s for ten. For 11 women (32%) it was not possible to achieve ten SWS at T1 as placental expulsion immediately followed the birth of the newborn. One patient experienced placental retention and only measurements at T1 were performed. For all other patients, we were successfully able to obtain all measures as intended. There was no difference in the mean shear wave speed between the three time points. After adjustments for confounders, we observed a significant correlation for total blood loss (correlation coefficient = − 0.26, p < 0.001, units of oxytocin (correlation coefficient = − 0.34, p = 0.03), and newborn weight (correlation coefficient = − 0.08, p = 0.001). It is feasible to assess uterine tonicity by shear wave imaging, after placental expulsion. We did not observe a variance in uterine tonicity between the three time points. Women who had higher blood loss, received more units of oxytocin and/or those with newborns of a higher weight exhibited lower shear wave speed measures.Joanna SichitiuJean-Yves MeuwlyDavid BaudDavid DesseauveNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joanna Sichitiu Jean-Yves Meuwly David Baud David Desseauve Using shear wave elastography to assess uterine tonicity after vaginal delivery
description	Abstract This study aims to evaluate the feasibility and clinical interest of shear wave elastography, by quantitatively estimating the baseline stiffness of the myometrium before and after placental expulsion. We conducted a prospective cohort study of women at term, without known risk factors for postpartum hemorrhage, who gave birth via spontaneous labor in our tertiary center. Myometrium tonicity was evaluated based on measurements of shear wave speed (SWS) in the anterior uterine corpus. All data points were collected by a single operator. Measurements were carried out at three different time points: after fetal delivery (T1), after placental delivery (T2) and 30 min after placental delivery (T3). Our primary objective was to assess the feasibility of this new imaging technique. Ten valid SWS measurements obtained at each of the three different time points were considered as a positive primary outcome. Our secondary objectives were to evaluate the difference in median myometrial shear wave velocity between each time point, as well as to determine the correlation between myometrial shear wave velocity and patients’ characteristics. 38 women were recruited during the study period, of whom 34 met the study criteria. 1017 SWS measurements were obtained. The median time to perform measurements was 16 s for one value, and 2 min 56 s for ten. For 11 women (32%) it was not possible to achieve ten SWS at T1 as placental expulsion immediately followed the birth of the newborn. One patient experienced placental retention and only measurements at T1 were performed. For all other patients, we were successfully able to obtain all measures as intended. There was no difference in the mean shear wave speed between the three time points. After adjustments for confounders, we observed a significant correlation for total blood loss (correlation coefficient = − 0.26, p < 0.001, units of oxytocin (correlation coefficient = − 0.34, p = 0.03), and newborn weight (correlation coefficient = − 0.08, p = 0.001). It is feasible to assess uterine tonicity by shear wave imaging, after placental expulsion. We did not observe a variance in uterine tonicity between the three time points. Women who had higher blood loss, received more units of oxytocin and/or those with newborns of a higher weight exhibited lower shear wave speed measures.
format	article
author	Joanna Sichitiu Jean-Yves Meuwly David Baud David Desseauve
author_facet	Joanna Sichitiu Jean-Yves Meuwly David Baud David Desseauve
author_sort	Joanna Sichitiu
title	Using shear wave elastography to assess uterine tonicity after vaginal delivery
title_short	Using shear wave elastography to assess uterine tonicity after vaginal delivery
title_full	Using shear wave elastography to assess uterine tonicity after vaginal delivery
title_fullStr	Using shear wave elastography to assess uterine tonicity after vaginal delivery
title_full_unstemmed	Using shear wave elastography to assess uterine tonicity after vaginal delivery
title_sort	using shear wave elastography to assess uterine tonicity after vaginal delivery
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9fb6945fa7604d1a86f4006c7de36785
work_keys_str_mv	AT joannasichitiu usingshearwaveelastographytoassessuterinetonicityaftervaginaldelivery AT jeanyvesmeuwly usingshearwaveelastographytoassessuterinetonicityaftervaginaldelivery AT davidbaud usingshearwaveelastographytoassessuterinetonicityaftervaginaldelivery AT daviddesseauve usingshearwaveelastographytoassessuterinetonicityaftervaginaldelivery
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Using shear wave elastography to assess uterine tonicity after vaginal delivery

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