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ObjectiveTo provide a standardized protocol for the measurement of cervical strain elastography, present its reproducibility,and analyze baseline clinical factors affecting the measurement of elastographic parameters. MethodsThis study was performed by the Korean Research Group of Cervical Elastography. We enrolled pregnant womenaccording to our study protocol. After measuring the cervical length, elastography was performed using the E-Cervix™quantification tool to measure the strain of the cervix using intrinsic compression. We evaluated 5 elastographicparameters, namely, the strain of the internal os of the cervix (IOS), strain of the external os of the cervix (EOS), ratioof the strain of IOS and EOS, elasticity contrast index, and hardness ratio. For baseline clinical factors, we examinedthe maternal body mass index, blood pressure, heart rate, uterine artery Doppler indices, and fetal presentation. ResultsWe established a specific protocol for the measurement of cervical elastography using the E cervix program. For allelastographic parameters, the intra-observer intraclass correlation coefficient (ICC) ranged from 0.633 to 0.723 forsingle measures and from 0.838 to 0.887 for average measures, and the inter-observer ICC ranged from 0.814 to 0.977for single measures and from 0.901 to 0.988 for average measures. Regression analysis showed that the measurementof the elastographic parameter was not affected by baseline clinical factors. ConclusionWe present a standardized protocol for the measurement of cervical elastography using intrinsic compression. According to this protocol, reproducibility was acceptable and the measurement of elastographic parameters was notaffected by the baseline clinical factors studied.

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