Khalifeh Adeeb, Quist-Nelson Johanna, Berghella Vincenzo
a Department of Obstetrics and Gynecology , Division of Maternal Fetal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University , Philadelphia , PA , USA.
J Matern Fetal Neonatal Med. 2017 Jun;30(12):1500-1503. doi: 10.1080/14767058.2016.1220521. Epub 2016 Sep 7.
To evaluate the incidence of implementation of universal cervical length (CL) screening for preterm birth (PTB) prevention among institutions with Maternal-Fetal Medicine (MFM) fellowship training in the United states.
In January 2015, we conducted a national survey of institutions with MFM Fellowship Programs regarding implementation of universal CL screening, defined as CL screening of women with singleton gestations without a prior spontaneous PTB. We identified whether a transabdominal ultrasound (TAU) or transvaginal ultrasound (TVU) was used for screening. Results were compared by geographical regions.
We identified 78 MFM fellowship programs nationwide, of which 100% responded to the survey, provided by MFM fellows (86%) and MFM division directors (14%). In January 2015, 53 programs (68%) had implemented a CL screening program, with 25 programs (32%) using TVU while the rest (36%) used TAU for CL screening. The 16 programs in the Midwest had the highest percent of CL screening (15 programs, 94%), with the highest use of TVU (8 programs 50%). The 24 programs in the South had the lowest percent of CL screening (14 programs, 58%) (odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.19-1.46) and the lowest use of TVU (3 programs,12.5%) (OR: 0.22, 95% CI: 0.05-0.78) compared to rest of US).
Universal CL screening has been implemented by over two-thirds of institutions with MFM Fellowship Programs, as of January 2015. Of these programs, about half screen by TAU and half by TVU.
评估美国设有母胎医学（MFM）专科培训项目的机构中，实施普遍宫颈长度（CL）筛查以预防早产（PTB）的发生率。
2015年1月，我们对设有MFM专科培训项目的机构进行了一项全国性调查，内容涉及普遍CL筛查的实施情况，普遍CL筛查定义为对既往无自发性PTB的单胎妊娠女性进行CL筛查。我们确定了筛查时使用的是经腹超声（TAU）还是经阴道超声（TVU）。结果按地理区域进行比较。
我们确定了全国78个MFM专科培训项目，其中100%对调查做出了回应，回应者包括MFM专科住院医师（86%）和MFM科室主任（14%）。2015年1月，53个项目（68%）实施了CL筛查项目，其中25个项目（32%）使用TVU进行CL筛查，其余项目（36%）使用TAU进行CL筛查。中西部地区的16个项目中CL筛查的比例最高（15个项目，94%），TVU的使用比例最高（8个项目，50%）。南部地区的24个项目中CL筛查的比例最低（14个项目，58%）（优势比[OR]：0.52，95%置信区间[CI]：0.19 - 1.46），与美国其他地区相比，TVU的使用比例最低（3个项目，12.5%）（OR：0.22，95% CI：0.05 - 0.78）。
截至2015年1月，超过三分之二设有MFM专科培训项目的机构实施了普遍CL筛查。在这些项目中，约一半通过TAU进行筛查，一半通过TVU进行筛查。
