Universal screening for short cervical length could cut preterm births
Wednesday, 15 March, 2017
A short cervical length in mid-pregnancy can dramatically increase the risk of preterm birth and most cases of preterm birth occur with no prior history. A team of researchers from (UWA) said that measuring the length of a woman鈥檚 cervix at mid-pregnancy can help decrease the risk of preterm delivery.
Preterm birth is the largest cause of infant death and occurs in 8% of births in Australia (26,000 babies every year).
The UWA team is part of a state-wide initiative, , which aims to lower the rate of preterm birth across WA.
Lead researcher and PhD student Michelle Pedretti, from , said as part of the initiative, the team was visiting doctors and medical professionals throughout the state to help them understand the importance of cervical length screening during mid-pregnancy.
鈥淲e are also helping medical practitioners evaluate the best ways of screening the cervix, using an ultrasound,鈥 Pedretti said.
鈥淔or women at low-risk of preterm birth it has been suggested a transabdominal ultrasound is one way to assess the cervical length, but emerging data on this is now showing this is not as accurate as the transvaginal method.鈥
Women鈥檚 attitudes towards the two scanning methods are also being investigated by the researchers.
鈥淎n imaging technique is important to achieve the most accurate measurement of the cervical length in mid-pregnancy and the education of medical practitioners has been shown to be effective in increasing both the competency and quality of the cervical length measurement. There are several cervical length competency courses available to sonographers and imaging staff,鈥 she said.
Pedretti said that currently there was great debate about whether to implement cervical length screening in all pregnancies or just restrict it to those at the greatest risk.
鈥淥pponents to cervical length screening have raised concerns about the lack of universal access there is to a transvaginal ultrasound (the method of choice for cervical length measurement), and the need for standardised protocols such as consistent measurement, treatment standards and cost effectiveness of treatments,鈥 she said.
Given that there are treatments available to reduce the risk once it鈥檚 identified, there appears to be a clear role for routine cervical length screening as part of the regular pregnancy ultrasound examinations.
Pedretti explained, 鈥淭here is also strong evidence supporting the use of vaginal progesterone in women with a short mid-pregnancy cervix to significantly reduce the risk of preterm birth. This is effective mainly for women carrying one baby but recent data is now demonstrating it is effective for twin pregnancies too.鈥
The research has been published in the .
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