Table of contents
Preterm labor
What's new
Updated 2024 SMFM guidelines for the management of short cervix in pregnant patients with no history of spontaneous preterm birth.
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of preterm labor are prepared by our editorial team based on guidelines from the Endocrine Society (ES 2024), the Society for Maternal-Fetal Medicine (SMFM 2024), the European Consensus Group on Respiratory Distress Syndrome (ECG-RDS 2023), the Society of Obstetricians and Gynaecologists of Canada (SOGC 2022), the American College of Obstetricians and ...
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Screening and diagnosis
Indications for screening
As per SMFM 2024 guidelines:
Use a transvaginal approach for all cervical length measurements to guide therapeutic management.
B
Use a mid-trimester cervical length of ≤ 25 mm to diagnose short cervix in singleton pregnancies with no previous history of spontaneous preterm birth.
B
Diagnostic investigations
Medical management
Setting of care: as per ECG-RDS 2023 guidelines, transfer pregnant females at high risk of preterm birth < 28-30 weeks of gestation to perinatal centers with experience in the management of respiratory distress syndrome.
B
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Corticosteroids
Tocolytics
Antibiotics
Therapeutic procedures
Mode of delivery: as per WHO 2015 guidelines, do not perform routine C-section to improve preterm infant outcomes, regardless of cephalic or breech presentation.
D
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Umbilical cord clamping
Preventative measures
Progesterone: as per SMFM 2024 guidelines, offer vaginal progesterone to reduce the risk of preterm birth in asymptomatic patients with a singleton pregnancy and a transvaginal cervical length ≤ 20 mm diagnosed before 24 weeks of gestation.
A
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Cervical cerclage
Cervical pessary
Bed rest
Vitamin D supplementation