To evaluate the incidence of implementation of universal cervical length (CL) screening for preterm birth (PTB) prevention among institutions with Maternal-Fetal Medicine (MFM) fellowship training in the United States.
In January 2015, we conducted a national survey of institutions with MFM Fellowship Programs regarding implementation of universal CL screening, defined as CL screening of women with singleton gestations without a prior spontaneous PTB. We also identified whether a transabdominal ultrasound (TAU) or transvaginal ultrasound (TVU) was used for screening. Results were compared by geographical regions. We also assessed if a low obstetrical volume (annual deliveries<3000) affected implementation of TVU CL screening program.
We identified 78 MFM fellowship programs, of which 100% responded to the survey. Fifty-three programs (68%) had implemented a CL screening program, with 25 programs (32%) using TVU while the rest (36%) used TAU for CL screening. The Midwest had the highest percent of CL screening (94%), with the highest use of TVU (50%). The South had the lowest percent of CL screening (58%) (OR 0.52 [0.19–1.46]) and the lowest use of TVU (12.5%) (OR 0.22 [0.05–0.78]) compared to rest of the United States. Lower annual obstetrical volume did not affect the likelihood of implementing a program using TVU (7.6%) compared to programs having higher obstetrical volume (24.3%) (OR 0.73 [0.24–2.17]).
Universal CL screening has been implemented by over two thirds of institutions with MFM Fellowship Programs. Of these programs, approximately half screen by TAU and half by TVU.
Thomas Jefferson University Hospitals, Philadelphia, PA
Financial Disclosure: The authors did not report any potential conflicts of interest.