Abstract
An accurate transvaginal ultrasound (TVU) cervical length (CL) is paramount to obtain the best prediction for preterm birth (PTB). TVU CL should be optimally obtained when a lower uterine segment (LUS) contraction (CTX) is not seen. For universal TVU CL screening at around 20 weeks, the options are to do the TVU soon after bladder void (LUS CTXs present in 16-43% of this approach), or to wait until the end of the anatomy scan (ideally within 30 minutes after bladder voiding) to decrease the chance of a LUS CTX. If the LUS CTX persists even after waiting up to 20 minutes or more, only the true TVU CL should be reported. In particular in patients with a prior spontaneous PTB, if the LUS CTX persists, the TVU CL can be repeated in 7 days or less even in the presence of a normal (>25mm) CL. Like a blood pressure cuff must be of the right size for proper BP measurement, and a glucometer must be properly calibrated, screening with TVU CL should only be done following a proper and standardized technique, including avoiding as much as feasible the presence of LUS CTXs.
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