Can cervical length monitoring and treatment affect prematurity rate?

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Can cervical length monitoring and treatment affect prematurity rate? Authors: M. Terrani, M.D.**, F. Gonzales, M.D.**, B. Petrikovsky, M.D., PhD*, A. Dillon, BS RDMS** Institutions: Ocean Perinatology, Wyckoff Heights Medical Center Objective: Prematurity remains a major contributor to perinatal morbidity and mortality. In 2007 the Institute of Medicine reported that the annual costs associated with preterm births exceed $26 billion. In spite of enhanced efforts, the rates of prematurity didn't change much. It appears, however, that in a subset of patients with progressively decreasing cervical length surgical or medical interventions may be beneficial. Gestational age at birth Study group (N=1319) Control group (N=2518) Under 32 weeks 30 2.3% 78 3.1% * More than 32 weeks, less than 37 weeks 55 4.17% 152 6.03% ** Total preterm: 85 6.47% 230 9.13% * RESULTS: A total of 1,319 patients comprised the study group and 2,518 – control group. Patients who delivered at less than 32 weeks were considered extreme prematurity, less than 37 weeks – moderate prematurity Materials and methods: Our protocol includes cervical length measurements at 12, 16, and 20 weeks of pregnancy using transvaginal approach in all pregnant patients. A cervical length of less than 25 mm served as an indication for interventions. Preterm birth was defined as a delivery between more than 24 and less than 37 weeks of pregnancy, and further subdivided into the ones delivered at less than 32 weeks of pregnancy and those delivered between 32 and 37 weeks.