Guideline-Based Facts You Should Know

Cervical length measurement is not a routine screening test for all pregnant women, but it is a crucial tool in selected cases to assess the risk of preterm birth.

🔍 Who SHOULD have cervical length assessment?

According to ACOG, SMFM, and RCOG guidelines, cervical length measurement is recommended for women with:

• A history of spontaneous preterm birth

• Second-trimester pregnancy losses

• Symptoms of threatened preterm labor

• Multiple pregnancy (twins or more)

• Previous cervical surgery (LEEP, cone biopsy)

• Uterine anomalies

• An incidentally discovered short cervix on ultrasound

⏱️ When is the BEST time to measure cervical length?

• 16–24 weeks of gestation

• This is the window where cervical length has the highest predictive value

• Routine measurement after 24 weeks is not recommended for screening

📍 How should it be measured?

✔ Transvaginal ultrasound is the gold standard

❌ Transabdominal ultrasound is not reliable for accurate cervical assessment

⚠️ What is considered a “short cervix”?

• Cervical length <25 mm before 24 weeks

→ Associated with increased risk of preterm birth

🩺 Why does this measurement matter?

Because it can change management, including: 

• Vaginal progesterone

• Cervical cerclage (in selected high-risk cases)

• Increased surveillance and timely intervention

🔑 Key Guideline Message

✔ Cervical length screening should be risk-based, not universal

✔ Proper timing and technique are essential

✔ Early identification can significantly reduce preterm birth risk

Dr Rabab Cares 🤍

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