Menzies School of Health Research, Charles Darwin University.
Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Aust N Z J Obstet Gynaecol. 2023 Aug;63(4):521-526. doi: 10.1111/ajo.13676. Epub 2023 Apr 4.
Reducing rates of preterm birth (PTB) remains a significant challenge. The Northern Territory (NT) records some of the highest rates of PTB in the country, especially in First Nations women. In 2014, a Western Australian (WA) preterm birth prevention initiative involved the implementation of seven key initiatives. One of these was routine mid-trimester cervical length measurement. The initiative successfully reduced PTB rates following its first year of implementation. This was the first successful reduction in PTB, including the earlier gestational ages, across a population.
To assess the uptake of routine cervical length measurement in the Top End of the NT after the success of the WA PTB prevention initiative and assess if treatment of a short cervix improved PTB rates.
A retrospective cohort study of all women who received antenatal care and delivered their baby at the NT's only tertiary hospital was performed. Mid-trimester ultrasound scan data were collected from two separate time windows, before and after the implementation of the WA intervention. Treatments and gestational age at birth were recorded.
Adoption of routine screening of cervical length measurement at mid-trimester ultrasound in the NT was successful, increasing from 4 to 88%. Detection rates of short cervix doubled. However, there was no difference to PTB rates despite targeted management.
PTB remains a significant challenge in the NT, especially for First Nations women who are found to have a short cervix more commonly than non-Indigenous women in the Top End.
降低早产率（PTB）仍然是一个重大挑战。北领地（NT）的 PTB 发生率位居全国前列，尤其是在原住民女性中。2014 年，西澳（WA）的一项早产预防计划实施了 7 项主要举措。其中之一是常规进行妊娠中期宫颈长度测量。该计划在实施的第一年就成功降低了 PTB 率。这是首次在一个人群中成功降低 PTB 率，包括更早的妊娠周数。
在 WA 的 PTB 预防计划成功实施后，评估北领地顶端地区常规宫颈长度测量的采用情况，并评估治疗短宫颈是否能改善 PTB 率。
对 NT 唯一的三级医院接受产前护理并分娩的所有妇女进行回顾性队列研究。从中收集了两次不同时间窗口（WA 干预实施前和实施后）的妊娠中期超声扫描数据。记录了治疗方法和分娩时的胎龄。
NT 成功地采用了妊娠中期超声常规筛查宫颈长度，从 4%增加到 88%。短宫颈的检出率增加了一倍。然而，尽管进行了有针对性的管理，PTB 率并没有差异。
PTB 仍然是 NT 的一个重大挑战，尤其是在原住民妇女中，她们在顶端地区比非原住民妇女更常见地发现短宫颈。
