Cervical strain elastography to predict response to labor induction at late-term pregnancy in nulliparous women: A prospective cohort study

Cervical tension elastography represents a novel noninvasive approach for assessing cervical stiffness and predicting the outcomes of labor induction. However, its additive value along with cervical length (CL) measurement is unknown. This study aimed to evaluate the predictive value of cervical tension elastography, particularly stiffness ratio and CL, for successful labor induction in nulliparous women during late pregnancy. This prospective study was conducted at 2 healthcare centers, Eskişehir City Hospital and Hitit University Erol Olçok Education and Research Hospital, from May 2024 to June 2024. A total of 50 nulliparous women were included in the study, of whom 43 had vaginal delivery and 7 underwent cesarean section. Cervical stiffness ratio and CL were measured using cervical tension elastography before induction. The statistical analysis was performed using IBM SPSS (Chicago) version 24.0. Continuous variables were analyzed using t-tests or nonparametric tests, and chi-square tests were used for categorical variables. Receiver operating characteristic analysis was also conducted to assess predictive values. Among the participants, 14% (7/50) experienced induction of labor failure, which aligned with global rates (17.3%-36.8%). CL and stiffness ratio, assessed via strain elastography, showed no significant predictive value for induction of labor success (P > .05). Receiver operating characteristic analysis demonstrated poor discrimination, with area under the curve values of 0.58 for CL and 0.55 for stiffness ratio. When measured in conjunction with CL, the cervical stiffness ratio was not found to improve the predictability of labor induction. Larger studies are required to validate these preliminary findings in more diverse populations.