Screening healthy women with a singleton pregnancy for a short cervical length

Spontaneous preterm delivery is the single most important cause of perinatal
mortality in the Western world. Although it is already known that cervical
length measurement at 20 to 22 weeks can identify women at increased risk for
preterm delivery, an effective treatment has not been available until recently.
In addition, there are no guidelines regarding cut-off values for cervical
length available. In august 2007, Fonseca et al. published in the New England
Journal of Medicine that the risk of preterm delivery in women with a shortened
cervix could be decreased with 50% due to treatment with progesterone. However,
there was no statistically significant effect on neonatal outcome, possibly due
to a lack of statistical power.

To evaluate whether a screening program with cervical length measurement to
find women at risk for a preterm delivery, is cost-effective. Women with a
short cervical length are asked to take part in a follow-up study (the Tripple
P treat study) that evaluates whether subsequent progesterone treatment is
effective.

Multicenter observational cohort study.

We don*t expect patients to experience the cervical length measurements as a
burden. Patients exhibiting a short cervical length, have an increased risk of
preterm birth. They will be asked to enter the follow-up clinical trial where
progesterone is administered, which may possibly decrease the preterm birth
rate.