Decrease in the incidence of threatened preterm labor after implementation of transvaginal ultrasound cervical length...

Area of Science:

• Maternal-fetal medicine
• Diagnostic imaging in obstetrics
• Public health in pregnancy

Background:

• The impact of universal second-trimester transvaginal ultrasound (TVU) cervical length (CL) screening on preterm labor (PTL) symptoms in asymptomatic women without prior spontaneous preterm birth (SPTB) remains unclear.
• Assessing the effectiveness of screening protocols is crucial for optimizing obstetric care and improving pregnancy outcomes.

Purpose of the Study:

• To evaluate the incidence of threatened PTL before and after implementing universal second-trimester TVU CL screening in a hospital setting.
• To determine if routine CL screening influences the rate of PTL presentations and admissions.

Main Methods:

• A retrospective cohort study compared singleton gestations without prior SPTB presenting with threatened PTL in 2011 (pre-screening) and 2014 (post-screening).
• Universal TVU CL screening was introduced in January 2012 for singleton gestations between 18 0/7 and 23 6/7 weeks.
• Primary outcome: incidence of threatened PTL; Secondary outcomes: incidence of PTL admissions and length of hospital stay.

Main Results:

• A significant decrease in the incidence of threatened PTL was observed, from 11.1% in 2011 to 6.7% in 2014 (p < .001).
• The rate of admission for PTL also significantly decreased from 2.3% in 2011 to 1.4% in 2014 (p = .04).
• No significant difference was found in the length of hospital stay between the two groups.

Conclusions:

• Universal transvaginal ultrasound (TVU) cervical length (CL) screening in women without a history of spontaneous preterm birth (SPTB) is associated with a reduction in threatened preterm labor (PTL) and PTL admissions.
• Implementing a universal second-trimester CL screening program can be an effective strategy to decrease the frequency of PTL symptoms and hospital admissions.