{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:25:34Z","timestamp":1765232734278,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"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":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Preterm birth is the leading cause of death in children under the age of five\u00a0years. Transvaginal cervical length (<jats:styled-content style=\"fixed-case\">TVCL<\/jats:styled-content>) assessment can be used to predict preterm delivery risk at the mid\u2010trimester scan. To optimise the screening tool, developing and maintaining quality standards is important.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To develop an Australian reference range for <jats:styled-content style=\"fixed-case\">TVCL<\/jats:styled-content> at 18.0\u201321.0\u00a0weeks\u2019 gestation, quality standards for measurement and audit mechanisms for ultrasound operators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective audit was performed of consecutive patients scanned at 18.0\u201321.0\u00a0weeks\u2019 gestation. Each <jats:styled-content style=\"fixed-case\">TVCL<\/jats:styled-content> measurement ultrasound image was reviewed, and exclusions were made based on a defined set of quality criteria. Fractional polynomial Bayesian methodology was used to establish a reference range. Central tendency, dispersion plots and cumulative sum charts for operators in the original reference range cohort were created. These plots were then applied to a second validation cohort of operators to establish the efficacy of this quality assurance audit tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median <jats:styled-content style=\"fixed-case\">TVCL<\/jats:styled-content> from 1031 participants was 36.0\u00a0mm (interquartile range 32.7\u201340.0\u00a0mm), which was independent of gestational age. The quality audit tool was applied to 15 operators from the reference cohort with a mean cervix length multiple of the median of 1.01 and a mean <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> log10 cervix length multiple of the median of 0.06. Of the 22 operators in the validation cohort, 20 (90.9%) demonstrated ideal or acceptable central tendency results, and 19 (86.4%) remained in the appropriate cumulative sum zone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An Australian cervix length measurement reference range at 18.0\u201321.0\u00a0weeks\u2019 gestation has been developed along with a validated quality assurance audit tool for ultrasound operators.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12984","type":"journal-article","created":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T12:56:28Z","timestamp":1559134588000},"page":"55-62","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Developing a quality assurance program for transvaginal cervical length measurement at 18\u201321 weeks\u2019 gestation"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4793-2350","authenticated-orcid":false,"given":"Casey","family":"Filce","sequence":"first","affiliation":[{"name":"Discipline of Obstetrics, Gynaecology and Neonatology Faculty of Medicine University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Hyett","sequence":"additional","affiliation":[{"name":"Discipline of Obstetrics, Gynaecology and Neonatology Faculty of Medicine University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daljit","family":"Sahota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Faculty of Medicine Chinese University of Hong Kong New Territories Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Wilson","sequence":"additional","affiliation":[{"name":"Discipline of Obstetrics, Gynaecology and Neonatology Faculty of Medicine University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8979-4534","authenticated-orcid":false,"given":"Andrew","family":"McLennan","sequence":"additional","affiliation":[{"name":"Discipline of Obstetrics, Gynaecology and Neonatology Faculty of Medicine University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,29]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Who.int [Internet].Geneva:World Health Organisation;2018. [cited 2018 May 15]. Available from:http:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/preterm-birth."},{"volume-title":"Australia's Mothers and Babies 2014\u2014in brief. Perinatal statistics series no. 32. Cat no. PER 87","year":"2016","author":"Australian Institute of Health and Welfare","key":"e_1_2_5_3_1"},{"key":"e_1_2_5_4_1","unstructured":"Marchofdimes.org [Internet].White Plains (NY):March of Dimes;2018. [2018 May 15]. The impact of premature birth on society. 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