OBSTETRICS Perspectives on the Management of the Short Cervix Identified by Transvaginal Ultrasound During Pregnancy: An Update for Canadian

A shortened cervix is often considered to be equivalent to cervical insufficiency, and a cerclage may be offered as an intervention to prolong pregnancy; however, we may not be differentiating between true cervical insufficiency and intrauterine causes of cervical shortening. A recent meta-analysis found no significant reduction in preterm birth < 35 weeks ’ gestation in women with cerclage compared with no cerclage in the total population of women studied. However, there was a potentially significant reduction in preterm birth < 35 weeks among women with a singleton pregnancy (relative risk [RR] 0.74; 95 % confidence intervals [CI] 0.57–0.96), with a singleton pregnancy and a previous preterm birth (RR 0.61; 95 % CI 0.40–0.92), and with a singleton pregnancy with a previous mid-trimester loss (RR 0.57; 95 % CI 0.33–0.99). An increase wa