Transvaginal sonographic cervical length in first and second trimesters in a low‐risk population: a prospective study

• DOI: 10.1002/uog.17556
• Publication Date: 2017-06-22T12:16:40Z
• Authors: C. B. Wulff; L. Rode; S. Rosthøj; E. Hoseth; O. B. Petersen; A. Tabor
• Keywords: Second trimester

ABSTRACT Objectives To assess cervical length (CL) longitudinally between the first and second trimesters to determine proportion of women with short CL. The study also aimed if CL at 19–24 weeks' gestation could be identified time combined first‐trimester screening (cFTS) 11–14 gestation, in order potential value implementation for prediction preterm delivery a Danish population. Methods This was prospective longitudinal singleton pregnancy attending three University Hospitals Denmark from 1 November 2013 December 2014. Exclusion criteria were multiple pregnancy, uterine anomaly, cerclage or progesterone treatment inclusion. measured on transvaginal sonography weeks (Cx1), 19–21 (Cx2) 23–24 (Cx3), by trained operators as straight line external internal os. Women ≤ 25 mm referred maternal–fetal medicine specialist according standardized management protocol. Results Of 4904 eligible women, 3477 (71%) participated had Cx1 recorded. those, 3232 (93.0%) all scans. Median 37 mm, median Cx2 Cx3 40 mm. increased gestational age, 0.41% (95% CI, 0.19–0.62%) 1.79% 1.34–2.24%) Cx3. In total, second‐trimester (Cx2 Cx3) 2.0% ( n = 67), which 38.8% 26) detected weeks. probability 19 24 greater those shorter It nearly nine‐fold higher compared ≥ 35 (17% vs 2%). performance 50% 10% false‐positive rate. found that more than 1500 would need screened prevent one case spontaneous before 34 population such this study. Conclusions There is an association risk cervix trimester. Once observed, greatly increased. However, whether universal should implemented low‐risk depends cost–benefit analysis taking into account low proportions delivery. Copyright © 2017 ISUOG. Published John Wiley & Sons Ltd.