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Grand Rounds

Does Cervical Length Actually Predict Preterm Birth?

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PURPOSE:

This study by Esplin et al. (JAMA, 2017) analyzed cervical length and serial measurements of vaginal fetal fibronectin levels to determine whether they are  good predictors for spontaneous preterm birth.

METHODS:

Multi-center Prospective Observational Cohort Study

RESULTS:

9,410 nulliparous women of varied racial and ethnic backgrounds were included in the study.  5% of these women had spontaneous preterm deliveries.  Only 8% of the women who experienced spontaneous preterm birth had a cervical length of ≤ 25mm at 15-22 weeks gestation while 23.3% had a shortened cervical length at 22-30 weeks gestation. Among women with spontaneous preterm birth, fetal fibronectin levels of ≥ 50 ng/mL were seen in 7.3% of women at 16-22 weeks gestation and 8.1% in women at 22-30 weeks gestation. Based on the above, the authors concluded that neither cervical length nor  quantitative fetal fibronectin levels are useful in predicting spontaneous preterm birth in the setting of nulliparous women with singleton pregnancies.

Learn More – Primary Sources:

Predictive Accuracy of Serial Transvaginal Cervical Lengths and Quantitative Vaginal Fetal Fibronectin Levels for Spontaneous Preterm Birth Among Nulliparous Women

Unproven Technologies in Maternal-Fetal Medicine and the High Cost of US Health Care

Common tests for preterm birth not useful for routine screening of first-time pregnancies

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Related ObG Topics:

Does fetal fibronectin testing prevent preterm birth?

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