A pregnant woman at 24 weeks of gestation is found to have a cervical length of 27 mm on transvaginal…

Explanation

Core Concept: Cervical length screening and preterm birth risk. A transvaginal ultrasound (TVUS) cervical length of < 25 mm before 24 weeks is considered a 'short cervix' and warrants intervention (e.g., vaginal progesterone). A cervical length of 27 mm is within the normal limits (≥ 25 mm) and does not significantly increase the risk of preterm birth, thus requiring no medical or surgical intervention.

Clinical Presentation:

• Usually asymptomatic; often found on routine anatomy scan or indicated TVUS.

Diagnosis:

• First-line: Transvaginal ultrasound (TVUS) to accurately measure cervical length.
• Gold Standard: TVUS is the most accurate modality for cervical assessment.

Management:

• Acute: Reassurance and routine prenatal care.
• Definitive: Expectant management. (If the cervix were < 25 mm, vaginal progesterone would be indicated; cerclage is generally reserved for patients with a history of spontaneous preterm birth and a short cervix).