Patient Acceptability of Universal Transvaginal Cervical Length Screening Program Implementation at HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand

Abstract

Background: Preterm birth is a significant problem. It is a leading cause of early neonatal death. Transvaginal ultrasonography for cervical length measurement during second trimester could predict preterm labor. Vaginal progesterone reduced preterm birth incidence in pregnant women with short cervical length. Objective: To evaluate the acceptance rate of a universal transvaginal cervical length (TCL) screening program implementation. Materials and Methods: A retrospective cohort study of universal TCL before 24 weeks of gestation at the time of anatomical scan between 18 to 23+6 weeks from single center from July, 2017 through July, 2018. Pregnant woman with cervical length (CL) <20 millimeters (mm) were diagnosed cervical shortening and were offered treatment as protocol. Incidence of cervical shortening was assessed. Acceptance rates and factors for declining TCL screening were analyzed. The incidence of preterm birth before 34 weeks and 37 weeks were reported. Results: Three hundred forty-one Thai pregnant women were enrolled. Of those, 294 (86.2%) accepted TCL screening. Three pregnant woman (1.1%) had a CL <20 mm. Employed women and women who had income >10,000 Baht per month were likely to accept TCL screening (OR, 2.13; 95% CI, 1.14 to 3.98 and OR, 2.85; 95% CI, 1.37 to 5.95, respectively). The incidence of preterm birth was accounted for 8.9 percent in the acceptance and 2.1 percent in denial group. Conclusion: The universal transvaginal cervical length screening program at HRH Princess Maha Chakri Sirindhorn Medical Center was successfully implemented at 86.2% of acceptance rate. © JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND| 2022