Towards a New Paradigm in Preterm Birth Prevention: The Evolving Role of Transvaginal Ultrasonography and Progesterone

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Release Date: Dec 7, 2011          Expiration Date: Dec 7, 2012

Program Overview

Preterm delivery, which occurs in about 5%-13% of pregnancies, is the main cause of neonatal morbidity and mortality. Despite attempts, the rate of preterm delivery has not decreased in the last 50 years. Symptomatic treatment of pregnancies presenting in preterm labor with corticosteroids has improved perinatal outcomes, but has not reduced the incidence of preterm delivery. The lack of an adequate method of screening for high-risk groups and ineffective methods of prevention are the main causes of this failure. However, recent studies suggest that both problems can be overcome.


First, extensive evidence shows that measurement of cervical length (CL) by transvaginal ultrasound (TVU) at mid-gestation provides a useful method for predicting the likelihood of subsequent preterm birth (PTB). Second, once a short cervix has been identified, interventions such as cervical cerclage and use of prophylactic vaginal progesterone therapy may stop progression to preterm birth, resulting in improved outcomes. This symposium will attempt to elucidate these findings and treatment options, in order to minimize risk and enhance patient safety and survival.


Jason K. Baxter, MD, MSCP, FACOG
Division of Maternal-Fetal Medicine
Director of Research
Department of Obstertrics and Gynecology
Thomas Jefferson University
Philadelphia, PA
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Target Audience

This activity is intended for gynecologists and obstetricians.

Educational Objectives

This program is designed to address the following IOM competencies: provide patient-centered care and employ evidence-based practice.

At the conclusion of this activity, participants should be able to:

  • Discuss and explain the clinical and economic impact of PTB
  • Recognize patients at risk for PTB and initiate screening strategies
  • Explain the data linking the impact of the short cervix with PTB
  • Employ routine transvaginal ultrasonography to measure cervical length in all pregnant patients
  • Assess the risks/benefits of current and emerging interventions


This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Wayne State University School of Medicine and Rockpointe Corporation. The Wayne State University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The Wayne State University School of Medicine designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

For questions regarding CME credit, the post-test, or evaluation, please email:

Disclosure Information

It is our policy to ensure balance, independence, objectivity, and scientific rigor in all of our educational programs. Faculty, course directors, program planners/managers, have disclosed relevant financial relationships with commercial companies, and Wayne State University has a process in place to resolve any conflict of interest.

The faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Jason K. Baxter, MD, MSCP, FACOG: Grant/Research: Columbia Labs, Watson; Scientific Advisor: Watson

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Wayne State University: Nancy Jennett, MEd; David Pieper, PhD: Nothing to Disclose

Rockpointe: Carole Drexel, PhD; Robert Schneider, MSW; Paula Larson; Blair St. Amand; Bradley Pine; Jay Katz: Nothing to Disclose


There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME activity in its entirety, and then complete the post-test and evaluation.

To complete the evaluation online, choose the best answer to each question. The estimated time for completion of this activity is 1.0 hour.

To receive and print their certificates, participants must receive a score of 70% or above on the post-test.

FDA Disclosure

The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

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