Short cervix and preterm birth in the top end.

• Published in: Australian and New Zealand Journal of Obstetrics and Gynaecology
• Main Authors: Brown K, Lam CKM, Binks M
• Format: Article in Journal/Newspaper
• Language: English
• Published: Australia 2023
• Subjects: Menzies; First Nations
• Online Access: https://hdl.handle.net/10137/12442; https://doi.org/10.1111/ajo.13676; https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/37016503

BACKGROUND: 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. AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. Menzies School of Health Research, Charles Darwin University. Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.