The shortened cervix in pregnancy: Investigation and current management recommendations for primary caregivers

Preterm birth (PTB), defined as delivery before 37 weeks' gestation, is a multifactorial condition that can lead to neonatal mortality and morbidity. Short cervical length (CL) found on morphological scan is associated with an elevated risk of spontaneous PTB. Identifying these women at risk allows clinicians the opportunity to treat and prevent PTB.

This article reviews current approaches to the evaluation and management of a shortened CL at morphology scan and highlights important patient counselling points.

Current Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines provide consensus-based recommendations; a shortened cervix measuring less than 25 mm on a transvaginal ultrasound scan at 18-24 weeks' gestation requires management. There are three management pathways when a short cervix is identified on morphology scan: conservative, medical and surgical. General practitioners involved in the antenatal care of pregnant women may assist in counselling these women about their options.