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Shear Wave Elastography to Assess Perineal Body Stiffness During Labor

Rostaminia, Ghazaleh, MD*; Awad, Charbel, MD*; Chang, Cecilia, PhD; Sikdar, Siddhartha, PhD; Wei, Qi, PhD; Shobeiri, S. Abbas, MD, MBA*‡

Female Pelvic Medicine & Reconstructive Surgery: May 22, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000585
Original Article: PDF Only

Objectives The objective of this study was to evaluate perineal body stiffness intrapartum using shear wave elastography ultrasound and to study its association with maternal and labor characteristics.

Methods This was a prospective observational study. Pregnant women with term pregnancy who had been admitted for labor management were recruited into the study. Transperineal shear wave elastography of perineal body was performed. Maternal and labor data were retrieved from electronic medical charts.

Results Thirty-two patients' data were available for analysis. Mean (SD) melastography modulus was 15.33 (5.49). While comparing the mean elastography modulus across maternal and labor characteristics, the difference was statistically different between parity, cervical dilation, and perineal laceration presence groups (P < 0.05). The mean of elastography modulus of primiparous women with cervical dilation less than 3 cm was 21.47 kPa, whereas that of multiparous women was 13.17 kPa (P = 0.0511). Perineal laceration was more prevalent in women with stiffer perineal body. The risk of having perineal laceration compared with no perineal laceration was 29.1% higher for each additional unit increase in perineal body elastography modulus (odds ratio, 0.709; 95% confidence interval, 0.507–0.992).

Conclusions Shear wave elastography can be used to quantify perineal body stiffness. Primiparous women in early stages of labor have stiffer perineal body than multiparous women in any stage of labor and primiparous women in late stage of labor.

From the *Department of Obstetrics and Gynecology, INOVA Women's Hospital, Falls Church, VA;

Biostatistics, NorthShore University Health System/University of Chicago, Skokie, IL; and

Department of Bioengineering, George Mason University, Fairfax, VA.

Correspondence: S. Abbas Shobeiri, MD, MBA, Professor & Vice Chair, Gynecologic Subspecialties, INOVA Women's Hospital, Department of Obstetrics and Gynecology, 3300 Gallows Rd, Second Floor, South Tower, Falls Church, VA 22042-330 E-mail:

The inception, conduct, data gathering, and analysis for this study were performed at the INOVA Women's Hospital, Falls Church, Virginia. The authors have declared they have no conflicts of interest.

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