Clinical applications of uterine cervical length assessment by transvaginal ultrasonography for preventing preterm birth

a. Nemescu, M. Onofriescu

Abstract: Cervical length measured by transvaginal ultrasound is an effective screening test for preterm birth risk assessment. It has a good diagnostic value on all studied population groups. In symptomatic patients, the measurement of the cervical length by ultrasonography allows reducing the number of hospitalizations and focusing on the cases that really need a treatment. This method could be associated with existing routine mid-trimester ultrasound scan. Performed at 19-24 weeks, cervical length screening selects asymptomatic women with increased risk of preterm birth who could benefit from effective prophylaxis. Recent evidence supports administration of vaginal progesterone to asymptomatic low risk women with short cervix (less than 20 mm). Cervical cerclage or tracheloplasty can be reserved for a minority who develop a short cervical length by progesterone treatment resistance (less than 15 mm) or has a history of spontaneous preterm birth (less than 25 mm). In this regards, cervical length screening should become a routine to all pregnant women.
Keywords: cervical cerclage, cervical length, preterm birth, progesterone, ultrasonography