Short cervical length dilemma

Obstet Gynecol Clin North Am. 2015 Jun;42(2):241-54. doi: 10.1016/j.ogc.2015.01.003. Epub 2015 Mar 10.

Abstract

Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality. With research efforts, the rate of PTB decreased to 11.4% in 2013. Transvaginal ultrasound (TVU) cervical length (CL) screening predicts PTB. In asymptomatic singletons without prior spontaneous PTB (sPTB), TVU CL screening should be done. If the cervix is 20 mm or less, vaginal progesterone is indicated. In asymptomatic singletons with prior sPTB, serial CL screening is indicated. In multiple gestations, routine cervical screening is not indicated. In symptomatic women with preterm labor, TVU CL screening and fetal fibronectin testing is recommended.

Keywords: Cerclage; Cervical length; Pessary; Preterm birth; Progesterone; Short cervix.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Administration, Intravaginal
  • Adult
  • Cerclage, Cervical / methods*
  • Cervical Length Measurement / methods*
  • Cervix Uteri / abnormalities
  • Cervix Uteri / diagnostic imaging*
  • Cervix Uteri / pathology
  • Female
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Obstetric Labor, Premature / diagnostic imaging*
  • Organ Size
  • Pregnancy
  • Premature Birth / diagnostic imaging*
  • Premature Birth / prevention & control
  • Progesterone / administration & dosage
  • Progestins / administration & dosage
  • Risk Factors
  • Vagina / diagnostic imaging*
  • Vagina / drug effects

Substances

  • Progestins
  • Progesterone