The following is a summary of “Introduction of a universal transvaginal cervical length screening program is associated with a reduced preterm birth rate,” published in the FEBRUARY 2023 issue of Obstetrics and Gynecology by Figarella, et al.

Midtrimester ultrasound measurement of cervical length is a reliable predictor of preterm birth in singleton pregnancies. Therefore, for a study, researchers sought to evaluate the impact of a universal transvaginal cervical length screening program on the preterm birth rate.

The study consisted of a multicenter before-and-after study and a prospective cohort study called ECHOCOL. The before-and-after study included all women with a singleton pregnancy who delivered after 24 weeks’ gestation in the South East region of France from January 2012 to April 2018. The ECHOCOL cohort study was conducted from May 2015 to July 2018 and included 17 maternity hospitals in the same region. Both studies compared the rate of preterm birth before and after the introduction of universal cervical length screening. In addition, women with asymptomatic short cervix <25 mm were offered treatments such as vaginal progesterone, cerclage, or a pessary until 34 weeks gestation.

The preterm birth rate was significantly lower in period B compared to period A after adjusting for confounding factors (5.6% vs. 5.8%, adjusted odds ratio 0.92, 95% CI 0.89-0.95, P<.0001). The percentage of cervical length screening significantly increased from 28.9% in period A to 52.9% in period B (odds ratio 2.76, 95% CI 2.71-2.80, P<.0001). In the ECHOCOL cohort, 38 (1.1%) asymptomatic short cervices were detected, and 192 patients gave birth prematurely (11 with an asymptomatic short cervix and 181 without). The rate of preterm birth before 37 weeks of gestation showed a tendency towards reduction (from 5.8% to 5.5%), but the difference was not statistically significant (adjusted odds ratio 0.72, 95% CI 0.51-1.03, P=.068).

Implementing a universal cervical length screening and treatment policy during the second trimester of pregnancy significantly decreased the preterm birth rate.

Reference: ajog.org/article/S0002-9378(22)00614-7/fulltext