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

  • Am J Obstet Gynecol MFM

  • International Clinical Digest
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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 (
  • For all CLs, imminent delivery (

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.