Cervical length screening for predicting preterm birth: A comparative review of guidelines

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.
• Cervical length (CL) assessment is a potential predictor of PTB.
• Current clinical guidelines offer varying recommendations on CL screening.

Purpose of the Study:

• To analyze and compare international guidelines regarding the role of cervical length (CL) in predicting preterm birth (PTB).
• To identify consensus and discrepancies in CL screening recommendations for different obstetric populations.

Main Methods:

• Systematic review and comparative analysis of major obstetric and gynecological guidelines.
• Evaluation of guideline recommendations on CL assessment in asymptomatic women, women with a history of spontaneous PTB (sPTB), and those with multiple pregnancies.

Main Results:

• No consensus exists for universal CL screening in asymptomatic women without a history of sPTB.
• CL assessment is recommended for women with a history of sPTB due to high recurrence rates.
• Discrepancies noted in recommendations for CL assessment in asymptomatic women with multiple pregnancies.

Conclusions:

• Cervical length measurement is the most effective current method for predicting PTB, despite its limitations.
• Guideline harmonization is needed for consistent application of CL assessment in PTB prediction.
• Targeted CL screening in high-risk populations (e.g., history of sPTB) is supported by current evidence.