Using shear wave elastography to assess uterine tonicity after vaginal delivery.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_C8B6EF9F3221
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Using shear wave elastography to assess uterine tonicity after vaginal delivery.
Journal
Scientific reports
Author(s)
Sichitiu J., Meuwly J.Y., Baud D., Desseauve D.
ISSN
2045-2322 (Electronic)
ISSN-L
2045-2322
Publication state
Published
Issued date
17/05/2021
Peer-reviewed
Oui
Volume
11
Number
1
Pages
10420
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
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.
Pubmed
Open Access
Yes
Create date
25/05/2021 8:46
Last modification date
23/11/2022 7:15
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