{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:56:37Z","timestamp":1791420997734,"version":"4.3.3"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,5,24]],"date-time":"2011-05-24T00:00:00Z","timestamp":1306195200000},"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; Gyne"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether routine measurement of second\u2010trimester transvaginal cervical length by ultrasound in low\u2010risk singleton pregnancies is a cost\u2010effective strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a decision analysis model to compare the cost\u2010effectiveness of two strategies for identifying pregnancies at risk for preterm birth: (1) no routine cervical length screening and (2) a single routine transvaginal cervical length measurement at 18\u201324 weeks' gestation. In our model, women identified as being at increased risk (cervical length &lt; 1.5 cm) for preterm birth would be offered daily vaginal progesterone supplementation. We assumed that vaginal progesterone reduces preterm birth at &lt; 34 weeks' gestation by 45%. We also assumed that a decreased cervical length could result in additional costs (ultrasound scans, inpatient admission) without significantly improved neonatal outcomes. The main outcome measure was incremental cost\u2010effectiveness ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our model predicts that routine cervical\u2010length screening is a dominant strategy when compared to routine care. For every 100 000 women screened, $ 12 119 947 can be potentially saved (in 2010 US dollars) and 423.9 quality\u2010adjusted life\u2010years could be gained. Additionally, we estimate that 22 cases of neonatal death or long\u2010term neurologic deficits could be prevented per 100 000 women screened. Screening remained cost\u2010effective but was no longer the dominant strategy when cervical\u2010length ultrasound measurement costs exceeded $ 187 or when vaginal progesterone reduced delivery risk at &lt; 34 weeks by less than 20%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In low\u2010risk pregnancies, universal transvaginal cervical length ultrasound screening appears to be a cost\u2010effective strategy under a wide range of clinical circumstances (varied preterm birth rates, predictive values of a shortened cervix and costs). Copyright \u00a9 2011 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.8911","type":"journal-article","created":{"date-parts":[[2010,12,14]],"date-time":"2010-12-14T06:24:34Z","timestamp":1292307874000},"page":"32-37","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":141,"title":["Universal cervical\u2010length screening to prevent preterm birth: a cost\u2010effectiveness analysis"],"prefix":"10.1002","volume":"38","author":[{"given":"E. F.","family":"Werner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. S.","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. M.","family":"Pettker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. S.","family":"Buhimschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Copel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. F.","family":"Funai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. F.","family":"Thung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,5,24]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"1","article-title":"Births: Final Data for 2006","volume":"57","author":"Martin JA","year":"2009","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.106"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2004.08.006"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706475"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.111248"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70430-7"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70225-9"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00277-9"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.12050312.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067815"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000174582.79364.a7"},{"key":"e_1_2_6_14_2","first-page":"709","article-title":"Assessment of risk factors for preterm birth. 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