{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T21:25:24Z","timestamp":1773869124165,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Vaginal progesterone therapy significantly reduces preterm birth (PTB) rates in those high\u2010risk pregnancies with a sonographic short cervix (\u226425\u2009mm) and\/or a history of spontaneous PTB. Cervical length (CL) is routinely measured at the midtrimester morphology scan; however, CL surveillance thereafter is not currently recommended. Progesterone's precise mechanism of action remains unknown, though if it indeed influences CL, shortening after treatment initiation could indicate therapeutic failure and risk of PTB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim was to explore the utility of serial transvaginal ultrasound (TVU) measurement of CL at 16, 19 and 22\u2009weeks for predicting PTB in high\u2010risk pregnancies prescribed progesterone therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted involving women who attended the King Edward Memorial Hospital PTB Prevention Clinic from 2015 to 2019 and were prescribed progesterone therapy. CL was measured at 16, 19 and 22\u2009weeks by TVU. CL change across three time points was assessed using linear mixed models; then relationships between CL change between 16\u201319 and 19\u201322\u2009weeks and PTB were analysed using logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Term birth was most likely when CL did not decrease across both time periods. The addition of 16\u201319\u00a0week decrease in CL to a model, including CL at 19\u2009weeks alone, for predicting PTB increased sensitivity from 43.2 to 56.3%, specificity from 73.2 to 77.4%, and overall accuracy from 61.7 to 70.2%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For high\u2010risk women prescribed vaginal progesterone therapy, serial measurement of the cervix at 16 and 19\u2009weeks improves clinical ability to predict PTB from current recommendations of 19\u2010week measurement alone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13592","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T03:53:25Z","timestamp":1658980405000},"page":"198-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The clinical utility of ongoing sonographic cervix length surveillance in pregnancies prescribed vaginal progesterone 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