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Using Cervical Length Measurement for Lower Spontaneous Preterm Birth Rates Among Women With Threatened Preterm Labor

Chiossi, Giuseppe, MD; Saade, George, R., MD; Sibai, Baha, MD; Berghella, Vincenzo, MD

doi: 10.1097/AOG.0000000000002695
Preterm Birth: Current Commentary: PDF Only

Spontaneous preterm birth is a leading cause of perinatal morbidity and mortality; however, accurate identification of women who will deliver prematurely after the onset of uterine contractions is still challenging, because less than 10% actually give birth within 7 days of presentation. Risk stratification in women with preterm contractions would allow targeting of interventions such as corticosteroids, magnesium sulfate, and maternal transfer to a perinatal center to those who will indeed deliver preterm. Moreover, unnecessary treatments associated with potential complications could be avoided in symptomatic women who are unlikely to deliver preterm. Fetal fibronectin testing and cervical length measurement are the most used methods to assess the risk of preterm birth among symptomatic women. Interventional studies in singleton gestations suggest that assessment of cervical length, unlike fetal fibronectin testing, improves diagnostic accuracy and leads to better perinatal outcomes.

Assessment of cervical length, but not fetal fibronectin, improves management and outcomes of preterm labor, a leading cause of perinatal morbidity and mortality worldwide.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Medical Branch, Galveston, and the Department of Obstetrics, Gynecology and Reproductive Sciences, UT Health, University of Texas Medical School at Houston, Houston, Texas; and the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.

Corresponding author: Giuseppe Chiossi, MD, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0587; email: gichioss@utmb.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he has met the journal's requirements for authorship.

Received March 5, 2018. Revised April 2, 2018. Accepted April 12, 2018.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.