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Cervical screening for preterm delivery
Alec Welsh1, Kypros Nicolaides
1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London SE5 9RS, UK.
The ability of sonographic cervical length screening to detect those at risk of spontaneous preterm delivery has been extensively explored over the past few years. This applies both to high-risk and low-risk groups. Cervical length measurement appears to be superior to biochemical, microbiological or hormonal methods of screening. The screening technique has been standardized, but the cervical length for intervention and the timing and nature of intervention have not been defined. Cervical cerclage appears to be of use to prevent or arrest the progress of cervical dilation in high-risk cases, but the management of the screen-positive low-risk case has yet to be determined. Future management may be stratified according to actual cervical length, and prospective randomized trials of treatment for the short cervix are needed.
The ability of sonographic cervical length screening to detect those at risk of spontaneous preterm delivery has been extensively explored over the past few years. This applies both to high-risk and low-risk groups. Cervical length measurement appears to be superior to biochemical, microbiological or hormonal methods of screening. The screening technique has been standardized, but the cervical length for intervention and the timing and nature of intervention have not been defined. Cervical cerclage appears to be of use to prevent or arrest the progress of cervical dilation in high-risk cases, but the management of the screen-positive low-risk case has yet to be determined. Future management may be stratified according to actual cervical length, and prospective randomized trials of treatment for the short cervix are needed.
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