ArticleArchives of gynecology and obstetrics2026
Predictive value of uterine electromyography coupled with transvaginal ultrasound cervical assessment in women at risk of preterm delivery.
Article in Archives of gynecology and obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreterm birth is the leading cause of perinatal morbidity and mortality worldwide, with about 15 million preterm births occurring each year. Accurate prediction of preterm birth is essential for the implementation of effective interventions.
aimThis study evaluates the combined predictive value of uterine electromyography (EMG) and transvaginal ultrasound (TVUS) cervical parameters for preterm birth in high-risk singleton pregnancies, assessing its superiority over individual methods.
methodsA retrospective, propensity score-matched cohort study was conducted to collect data of pregnant women at high risk of preterm birth who gave birth in our hospital (Jan 2024-Apr 2025). After 1:1 matching, 180 participants were assigned to spontaneous preterm birth (sPTB, < 37 weeks, n = 90) or term birth (≥ 37 weeks, n = 90) groups. At 20-24 weeks, all underwent TVUS [cervical length (CL) and elastic strain rate (ESR)] and EMG [peak frequency (PK) and propagation velocity (PV)]. The primary aim was to compare the AUC of a combined model (CL + ESR + EMG-PV) versus CL alone. Secondary outcomes included group differences and each model's sensitivity, specificity, and NPV. Logistic regression was used for multivariable analysis, and the DeLong test compared AUCs.
resultsAfter PSM, the baseline data of the two groups were balanced (P > 0.05). The sPTB group had shorter CL and higher ESR, EMG-PK, and EMG-PV (all P < 0.001). Multivariate logistic regression identified CL (OR = 0.85), ESR (OR = 1.32), and EMG-PV (OR = 1.45) as independent predictors. The combined model (CL + ESR + EMG-PV) yielded a significantly higher AUC (0.93, 95%CI 0.89-0.97) than CL alone (0.85, 95%CI 0.79-0.91; DeLong test, P = 0.002). The combined model also demonstrated superior sensitivity (88.9%), specificity (91.1%), and NPV (94.4%) compared with individual models.
conclusionsIntegrating TVUS cervical assessment with EMG monitoring significantly enhances preterm birth prediction in high-risk singletons, offering improved risk stratification despite limitations from its single-center retrospective design requiring future validation.
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