What to do for asymptomatic short cervix at 23-28 weeks?

Takeaway

• Asymptomatic short cervical length (CL) remains a challenging clinical scenario.
• Delivery within 1-2 weeks after diagnosis of asymptomatic short CL is rare.

Why this matters

• A short cervix (≤25 mm) is a risk factor for preterm birth.
• Optimal management of asymptomatic short CL between 23 and 28 weeks of gestation is not clear.
• These authors suggest that the timing of antenatal corticosteroid administration should be based on additional findings, including preterm pre-labour rupture of membranes and signs and symptoms of preterm labour.

Key results

• 42.9% had a short CL prior to 23 weeks, and 57.1% had a short CL between 23 and 28 weeks of gestation.
• Shorter CL was associated with a shorter time to delivery (P=.03).
• Extremely short CL (<10 mm) was associated with a higher probability of preterm (<37 weeks) delivery (P=.002).
• For all CLs, imminent delivery (<1-2 weeks) was extremely uncommon (P=.17).

Study design

• Retrospective, cross-sectional, cohort study.
• Cohort was taken from a single centre between 2015 and 2018 (n=126).
• At this centre, routine CL screening is performed in the second trimester (18-24 weeks) during anatomical screening.
• Funding: None disclosed.

Limitations

• Small sample size.