Predictive value of cervical shear wave elastography combined with cervical morphological parameters for preterm birth after cerclage in patients with cervical insufficiency

Purpose: This study aims to investigate the predictive value of shear-wave elastography (SWE) parameters, combined with cervical morphological parameters [cervical length (CL) and anterior cervical angle (ACA)] for spontaneous preterm birth (sPTB) in patients with cervical insufficiency following transvaginal cervical cerclage, thereby providing a reference for early clinical intervention. Patients and methods: weeks were used. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for preterm birth. The predictive performance of individual indicators and their combination was evaluated using receiver operating characteristic (ROC) curve analysis. Results: < 0.001). ROC curve analysis revealed that the combined detection model achieved an area under the curve (AUC) of 0.962, which was significantly higher than that of any single indicator (AUC range: 0.614-0.931). The sensitivity, specificity, and Youden index of the combined model were 96.7, 94.5%, and 0.912, respectively. Conclusion: SWE parameters combined with cervical morphological parameters are closely associated with sPTB after cerclage in patients with cervical insufficiency. The combination of these three indicators significantly improves predictive performance, providing reliable imaging-based evidence for precise pregnancy risk assessment and individualized intervention strategies. Plain language summary: Cervical shear-wave elastography parameters, in combination with cervical morphological parameters (cervical length and anterior cervical angle), can effectively predict the risk of spontaneous preterm birth in patients with cervical insufficiency after cerclage. The predictive model integrating these indicators demonstrates high accuracy and provides a reliable tool for clinical assessment, supporting individualized pregnancy monitoring and intervention strategies.