{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:56:36Z","timestamp":1791420996167,"version":"4.3.3"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the feasibility and results of introducing a policy of universal screening for preterm delivery (PTD) by mid\u2010trimester cervical\u2010length (CL) measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cross\u2010sectional study of singleton pregnancies, transvaginal sonography for CL measurement was performed at 20\u201324\u2009weeks of gestation. Vaginal progesterone therapy was offered to women with CL\u00a0\u2264\u00a015\u2009mm. The incidence of spontaneous PTD (sPTD) according to CL and the distribution of CL measurements were assessed. Rate of PTD before implementation of screening was compared with that after.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 10\u2009506 singleton pregnancies were assessed. The decline rate was 1.32%. sPTD &lt;\u200932\u2009weeks, &lt;\u200934\u2009weeks and\u2009&lt;\u200937\u2009weeks occurred in 0.51%, 0.82% and 3.90% of pregnancies, respectively. CL measurement was best described by a mixture model distribution comprising a \u2018short\u2019 and a \u2018long\u2019 component. The percentage of the two components varied between subgroups of PTD, with the short component being greater the earlier the birth. CL, history of  miscarriage, smoking status and prior PTD were independent predictors in the construction of a model predictive of PTD\u2009&lt;\u200934\u2009weeks (area under the curve\u00a0=\u20090.74,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.001). The rate of sPTD &lt;\u200934\u2009weeks in women with CL\u2009\u2264\u200915\u2009mm receiving progesterone treatment was 20.4%. In the progesterone\u2010treated group, a plateau was observed in the increase in risk for PTD for CL 9\u201313\u2009mm, whereas below 9\u2009mm the risk increased exponentially. Following the introduction of mid\u2010trimester CL measurement, there was a trend for reduction in the rate of any PTD\u2009&lt;\u200934\u2009weeks of about 20% in comparison with the prescreening period (odds ratio\u2009=\u20090.81; 95% CI, 0.59\u20131.13).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Universal screening for PTD by transvaginal sonographic measurement of CL at 20\u201324\u2009weeks is feasible and well accepted by pregnant women. This policy identifies a very high\u2010risk group that may benefit from intervention. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.19050","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T07:52:31Z","timestamp":1521100351000},"page":"396-401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Implementation of universal screening for preterm delivery by mid\u2010trimester cervical\u2010length measurement"],"prefix":"10.1002","volume":"53","author":[{"given":"A. P.","family":"Souka","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, 3<sup>rd<\/sup> Department of Obstetrics and Gynaecology University of Athens Medical School, \u2018Attikon\u2019 University Hospital  Athens Greece"},{"name":"Fetal Medicine Unit Leto Maternity Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Papastefanou","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, 3<sup>rd<\/sup> Department of Obstetrics and Gynaecology University of Athens Medical School, \u2018Attikon\u2019 University Hospital  Athens Greece"},{"name":"Fetal Medicine Unit Leto Maternity Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Pilalis","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, 3<sup>rd<\/sup> Department of Obstetrics and Gynaecology University of Athens Medical School, \u2018Attikon\u2019 University Hospital  Athens Greece"},{"name":"Fetal Medicine Unit Leto Maternity Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Kassanos","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, 3<sup>rd<\/sup> Department of Obstetrics and Gynaecology University of Athens Medical School, \u2018Attikon\u2019 University Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Laboratory of Biometry Agricultural University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31821fd5b0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820ca847"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.02.064"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000173987.59595.e2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000192169.44775.76"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03203.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2011.30.7.997"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5174"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.12050312.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.32"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5333"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000428"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12622"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12721"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067815"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9017"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60030-0"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5174"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9073"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3182487e96"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.06.020"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.11010071.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001820"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.33.12.2159"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.12.020"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13407"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1159\/000381144"}],"container-title":["Ultrasound in Obstetrics &amp; 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