Cervical Length Measurement in Obstetrics: From Academic Luxury to Clinical Practice

Abstract

Preterm birth is the main cause of perinatal mortality and morbidity and can be very costly to the healthcare system. Although improvements in neonatal care have led to higher survival of very premature infants, there is a need for the development of a sensitive method with which to identify women at high risk of preterm delivery and find an effective strategy for the prevention of preterm labor.¹ Considering the increased incidence of preterm birth, it has become more important now to be able to early diagnose this problem. The measurement of cervical length to predict the risk of preterm birth can be extremely useful in diagnosing this condition. The use of transvaginal ultrasound in measuring cervical length is safe, reliable and well accepted by women.² The use of vaginal progesterone has shown to be effective in the prevention of preterm delivery in women with short cervix. Tocolytics are used to delay labor for a minimum of 24 to 48 hours³ for up to 1 week but they have not shown to improve neonatal outcomes and most have undesirable side effects. Steroids can assist with fetal lung maturity when the diagnosis of preterm labor is made,³ they can be used unnecessarily when preterm labor is misdiagnosed. The measurement of cervical length can also be helpful in patients with preterm premature rupture of membrane and in patients with the presence of amniotic fluid (AF) sluge.⁴ Therefore, performing cervical length measurements in all pregnant women and use it as a screening tool at around 20 weeks of pregnancy to identify patients at high risk of preterm labor can assist with true diagnosis. There is a great expectation from cervical assessment and subsequent addition of progesterone to reduce preterm birth and have better neonatal outcomes. The aim of this review is to bring forward evidence that highlights the importance of performing cervical length measurement in midpregnancy in all pregnant women to predict the risk of preterm birth. Medline, PubMed, MD Consult and Science Direct were searched using the terms cervical length measurement, ‘preterm delivery’, ‘amniotic fluid sludge’ and ‘treatment for preterm birth’. How to cite this article: Ahmed B, Hasnani Z. Cervical Length Measurement in Obstetrics: From Academic Luxury to Clinical Practice. Donald School J Ultrasound Obstet Gynecol 2012;6(1):93-96.