Universal cervical length screening for preterm birth prevention in the United States

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 identified whether a transabdominal ultrasound (TAU) or transvaginal ultrasound (TVU) was used for screening. Results were compared by geographical regions.

We identified 78 MFM fellowship programs nationwide, of which 100% responded to the survey, provided by MFM fellows (86%) and MFM division directors (14%). In January 2015, 53 programs (68%) had implemented a CL screening program, with 25 programs (32%) using TVU while the rest (36%) used TAU for CL screening. The 16 programs in the Midwest had the highest percent of CL screening (15 programs, 94%), with the highest use of TVU (8 programs 50%). The 24 programs in the South had the lowest percent of CL screening (14 programs, 58%) (odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.19-1.46) and the lowest use of TVU (3 programs,12.5%) (OR: 0.22, 95% CI: 0.05-0.78) compared to rest of US).

Universal CL screening has been implemented by over two-thirds of institutions with MFM Fellowship Programs, as of January 2015. Of these programs, about half screen by TAU and half by TVU.