INFORMATION
FOR
Future MOMS
Measuring cervical stiffness -
A world first in pregnancy care
Many pregnancies are accompanied by certain symptoms: a pulling sensation in the abdomen, abdominal pain or downward pressure. Especially in early pregnancy, these can be worrying symptoms. Fortunately, they are mostly harmless [10]. But the symptoms should always be assessed by a specialist, because for the health of mother and child it is important to recognise the few critical cases as early as possible.
The ETH spin-off Pregnolia is taking an innovative step into the future with its measuring device for the stiffness of the cervix. Pregnolia provides gynaecologists with a new device for prenatal care [1] and gives pregnant women a safe feeling for a healthy pregnancy. Current studies also give hope for effective, early detection of premature births [3].
A leap
in the pregnancy care
Until now, gynaecologists have been faced with a mystery: half of premature births occur quite suddenly without any prior symptoms or causes [4]. One of the reasons for a premature birth can be a cervical insufficiency. Softer cervical tissue or shortening can be signs of an impending premature birth [5]. Therefore, the condition of the cervix is examined during pregnancy. Pregnolia now makes it possible to measure cervical stiffness with an uncomplicated procedure - a world first in prenatal diagnostics [1][6].
The following health insurances cover the examination through their supplementary insurances:
myFlex Outpatient Insurance
Supplementary insurance
PRIMEO
Supplementary insurance Classic, Family, Jump
For all self-paying women, the examination costs 150 - 200 CHF
A measuring device for the Cervical Stiffness
Until now, cervical stiffness could only be determined by vaginal palpation with the fingers and the associated subjective assessment [7]. With the Pregnolia System, a reliable device is now available that can measure the stiffness precisely and quantitatively [1][2][6].
The Pregnolia measurement supports the assessment of premature birth risk:
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safe for you and your baby
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pain-free
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less intrusive and more hygienic than palpation
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no ultrasounds
The "SoftCervix" study at 12 Swiss hospitals is investigating whether cervical insufficiency can be detected earlier. For this purpose, the stiffness and length of the cervix are
measured in the 5th month. The stiffness is determined with the Pregnolia measuring device. This examination is supplemented by two ultrasound measurements [8].
Learn more about Pregnolia?
Watch our film here.
the cervix softens
before it shortens
During pregnancy, the cervix becomes softer and shorter. Eventually, the cervix will open completely at birth [5]. A very soft cervix can be a sign of an impending premature birth.
A clinical study by ETH Zurich and the University Hospital Zurich has shown that the cervix first softens during pregnancy and only then shortens [1][6]. This means that the Pregnolia System can identify a change in the cervix earlier than an ultrasound exam may detect a change in length. This is possible only with an objective and sensitive measurement device like the Pregnolia System, which is much more precise than the subjective method of palpation [2].
1] Badir, S. et al. (2013). Cervical softening occurs early in pregnancy: characterization of cervical stiffness in 100 healthy women using the aspiration technique. Prenat Diagn, 33(8), 737–741
The Pregnolia System
in use
The following gynaecology practices and clinics use Pregnolia's measuring device:
Basel
If you are interested in a measurement, please contact the practice directly.
Is your gynaecologist missing from the list? New practices are being added all the time and will be listed here. Contact her/him! Download the brochure for your next consultation. Your gynaecologist can contact us at any time.
Questions and answers about Preventive examination with the Pregnolia System
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Why should I have cervical stiffness determined?The determination of cervical stiffness provides additional information about the cervix and supports the assessment of the risk of premature birth.
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Does my baby feel anything from the cervical measurement?No, the baby does not feel anything from the measurement. The determination of cervical stiffness is gentle, localised and does not require ultrasound waves [1].
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Is the examination with the Pregnolia System suitable for me?The Pregnolia measurement can be carried out in most pregnancies during a regular pregnancy examination.
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Who covers the costs of the examination?The supplementary outpatient insurances of CSS, Helsana and Sanitas cover the examination with the Pregnolia measuring device. For all self-paying women, the examination costs 150-200 CHF.
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In which week of pregnancy (GW) can the measurement be taken, at the earliest?It makes most sense to take a measurement from the 18th gestational week (GW).
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What possible symptoms of premature birth should I make an appointment with my gynaecologist for?Always! Symptoms can be: Abdominal pain, pulling in the abdomen, downward pressure, spotting, leakage of fluid, or a “here we go” feeling.
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Which screening examinations are usually carried out or are part of the standard?The following examinations are frequently carried out: General condition, disorders, ultrasound, vaginal examination, swab tests, blood/urine examinations, blood pressure, pulse, weight check, fundal status/abdominal girth, fetal heart tones, fetal movements, oedema, varicose veins, and prenatal tests.
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When is a child a premature baby?A pregnancy lasts about 40 weeks. Children who are born before the 37th week are considered premature babies [4]. In Switzerland, this is every 15th child [7]. Premature babies are often too light and too small and need medical support to maintain their circulation [4].
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What can I do if my gynaecologist does not yet have the Pregnolia device?Talk to her/him! Download the brochure for your next consultation here. Your doctor can contact us at any time.
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What is there to consider specifically for the measurement of cervical stiffness in a high-risk pregnancy?The measurement can also be performed in high-risk pregnancies. If there is a risk (e.g., high/very young maternal age, twins, IVF, previous premature births, diabetes, previous caesarean sections, miscarriages, etc.) the pregnant woman is monitored closely, and more measurements of cervical stiffness may also be useful, for example.
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What are the chances of survival in the case of premature birth and how can the risk be reduced?The prognosis usually depends on the week of pregnancy in which the child is born. The later in pregnancy a premature birth occurs and the heavier the child is, the better its chances of survival [4]. The earlier a risk can be identified, the earlier the risk of premature birth can be treated.
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What measures are taken if the results of the measurement of cervical stiffness indicate a soft cervix?Your gynaecologist will discuss the best measures with you. These could be, for example: magnesium, bryophyllum, progesterone, physical rest, or pessary, etc.
References
[1] Badir S. et al., Cervical softening occurs early in pregnancy: characterization of cervical stiffness in 100 healthy women using the aspiration technique.
Prenatal Diagnosis 2013; 33(8): 737-741.
[2] Badir S. et al., Aspiration technique-based device is more reliable in cervical stiffness assessment than digital palpation.
BMC Pregnancy and Childbirth 2020; 20 (391).
[3] Parra-Saavedra M. et al., Prediction of preterm birth using the cervical consistency index. Ultrasound Obstet Gynecol 2011; 38: 44–51.
[4] March of Dimes, PMNCH, Save the children, Who. Born Too Soon: The Global Action Report on Preterm Birth. Eds CP. Howson, MV Kinney, JE Lawn.
World Health Organization. Geneva, 2012
[5] Word K., et al., Dynamics of Cervical Remodeling during Pregnancy and Parturition: Mechanisms and Current Concepts. Semin. Reprod. Med., pp. 69–80, 2007.
[6] Badir S. et al., A novel procedure for the mechanical characterization of the uterine cervix during pregnancy.
Journal of the Mechanical Behavior of Biomedical Materials 2013; 27:143-153.
[7] Feltovich H., Cervical evaluation. Obstet. Gynecol. 2017; 130(1):51–63.
[8] SoftCervix study: https://clinicaltrials.gov/ct2/show/NCT02037334
[9] Federal Statistical Office: https://www.bfs.admin.ch/bfs/de/home/statistiken/gesundheit/gesundheitszustand/gesundheit-neugeborenen.html
[10] Mayer I.E., Hussain H. Abdominal pain during pregnancy. Gastroenterology Clinics of North America 1998; 27(1):1-36.