SHORT CERVIX – WHAT NOW?

Abstract

Background: It is possible to predict preterm delivery (PD) before 34 weeks by ultrasound measurement of uterine cervical length (CL). This is the reason why this screening method is more frequently used in clinical practice. Methods: I extracted from PubMed database Crane’s sistematic review and articles about association of CL with PD and instructions what is necessary to take into consideration and what to do in case of a short cervix. Results: Majority of studies suggested CL of 25 mm as a cut-off point for selecting pregnancy as high risk for PD. Minority of studies also used 15 mm as a cut-off point. This inconsistency in selecting an unique cut-off point, as some authors showed, is a result of ignoring gestational age when measurement of CL is made. CL is usually measured until 24 weeks of pregnancy and value of US measurement of CL made later in pregnancy or role of follow-up measure- ments are still unclear. In cases with threatened preterm labour where CL is measured there was 66 % reduction of unnecessary tocolysis. US measurement of CL is of a little value if there is a progressive dilatation of cervix (Bishop score > 6). Shirodkar cerclage in women with short cervix does not reduce the risk for PD. Vaginal progesteron causes a 50 % decrease of incidence of PD in women with short cervix (CL 25 mm. Conclusions: US measurement of CL becomes reliable criteria for detecting pregnancies with increased risk for PD before 34 weeks of pregnancy. It enables individual risk calculation for PD with consideration of other risk factors.

Keywords

• kratek maternični vrat
• progesteron
• prezgodnji porod