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Obstetrics19 papers

Infection of cervix uteri

Last edited: 4/10/2026

Overview

A short cervix is defined as a cervical length of ≤25 mm on transvaginal ultrasound in the midtrimester. It is a predictor of spontaneous preterm birth, particularly in individuals without a prior history of preterm birth 1.

Diagnosis

  • Cervical length assessment should be performed using a transvaginal ultrasound approach, following standardized procedures 1.
  • A midtrimester cervical length of ≤25 mm is used to diagnose a short cervix in individuals with a singleton gestation and no prior history of spontaneous preterm birth 1.

    • Management

  • Asymptomatic individuals with a singleton gestation and a transvaginal cervical length of ≤20 mm diagnosed before 24 weeks of gestation should be prescribed vaginal progesterone to reduce the risk of preterm birth 1.
  • Treatment with vaginal progesterone should be considered for cervical lengths between 21 to 25 mm, based on shared decision-making 1.
  • 17-alpha hydroxyprogesterone caproate is not recommended for the treatment of a short cervix 1.

    • Special Populations

  • This guidance applies to individuals with a singleton gestation and no previous history of spontaneous preterm birth 1.

    • Key Recommendations

  • All cervical length measurements used to guide therapeutic recommendations should be performed using a transvaginal approach and in accordance with standardized procedures 1. (Evidence: Strong)
  • A midtrimester cervical length of ≤25 mm should be used to diagnose a short cervix in individuals with a singleton gestation and no previous history of spontaneous preterm birth 1. (Evidence: Strong)
  • Asymptomatic individuals with a singleton gestation and a transvaginal cervical length of ≤20 mm diagnosed before 24 weeks of gestation should be prescribed vaginal progesterone to reduce the risk of preterm birth 1. (Evidence: Strong)

    • References

    1 Biggio J. SMFM Consult Series #70: Management of short cervix in individuals without a history of spontaneous preterm birth. American journal of obstetrics and gynecology 2024. link

    Original source

    1. [1]
      SMFM Consult Series #70: Management of short cervix in individuals without a history of spontaneous preterm birth. — Biggio J American journal of obstetrics and gynecology (2024)
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