{
  "abstract": "Background/Objectives: Vaginal progesterone reduces preterm birth in women with a short mid-trimester cervix, and the treatment threshold has moved from 15–20 mm to 25 mm; how this change reached everyday practice is rarely documented. We describe cervical length (CL) distribution, short-cervix prevalence, preterm-birth and neonatal outcomes and the evolution of progesterone counselling in routine screening. Methods: Retrospective cohort of singleton pregnancies with a CL measurement at 16+0–24+6 weeks in one Romanian fetal-medicine centre (2011–2026). CL was measured transabdominally and, when <30 mm, transvaginally (FMF criteria). Documented counselling was extracted from the structured report text by keyword search; delivery outcome was available for 20.3% of pregnancies, so outcome analyses describe the outcome-ascertained subgroup. Results: Among 20,168 pregnancies, median CL was 35.8 mm; CL was <25 mm in 1.92% (95% CI 1.74–2.12) and <15 mm in 0.60%, and five times more frequent after a previous late miscarriage or preterm birth. In 4087 pregnancies with known delivery, birth < 34 weeks rose from 1.9% at CL ≥ 35 mm to 26.1% at <15 mm; CL < 25 mm carried an adjusted odds ratio of 9.1 (4.6–17.9) for birth < 34 weeks and birth weight < 1500 g in 8/92 (8.7%) vs. 41/3894 (1.1%), yet identified only 12% of births < 34 weeks (AUC 0.59); 88% (95% CI 79–93%) of births < 34 weeks followed a CL ≥ 25 mm. An explicit progesterone mention at 20–24.9 mm rose from 49.2% in 2011–2016 to 73.3% in 2017–2026 (p = 0.002); a data-driven change-point search located the shift in 2017–2019 (81% of clustered bootstrap samples), as a level change without trend, and the period effect persisted after adjustment for population composition (OR 5.0, 2.3–10.9). Before 2017 the operational threshold was ≈22 mm. Conclusions: A short cervix is rare but carries nine-fold adjusted odds of early preterm birth; screening identifies a small very-high-risk group rather than most preterm births. The structured report captured, in real time, the migration of documented counselling to the full ≤25 mm range between 2017 and 2019; neonatal findings are exploratory.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Obstetrics and Gynecology, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania",
    "Maternal-Fetal Medicine Center, 300331 Timișoara, Romania",
    "Department of Obstetrics-Gynecology and Neonatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Maria Cezara Mureșan",
      "orcid": "0000-0003-2661-8485"
    },
    {
      "affs": [
        1
      ],
      "name": "Marius Bogdan Mureșan",
      "orcid": "0009-0000-9378-3435"
    },
    {
      "affs": [
        1
      ],
      "name": "Dan Dumitrașcu Biriș"
    },
    {
      "affs": [
        2
      ],
      "name": "Daniela-Eugenia Popescu",
      "orcid": "0000-0002-4986-8025"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0ptenmxagar9s.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218310",
  "fulltext_url": null,
  "id": "0ptenmxagar9s",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8310",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Preterm Birth and Chorioamnionitis"
    ]
  ],
  "openalex": "W7223983772",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-25",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/0ptenmxagar9s.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15218310",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8310"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Preterm Birth and Chorioamnionitis",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Mid-Trimester Cervical Length Screening in Routine Practice: Short-Cervix Prevalence, Preterm Birth and the Shift of the Progesterone Counselling Threshold from 20 to 25 mm in a 15-Year Single-Centre Cohort of 20,168 Singleton Pregnancies",
  "title_text": "Mid-Trimester Cervical Length Screening in Routine Practice: Short-Cervix Prevalence, Preterm Birth and the Shift of the Progesterone Counselling Threshold from 20 to 25 mm in a 15-Year Single-Centre Cohort of 20,168 Singleton Pregnancies",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:01Z",
  "url": "https://research.draconitic.com/paper/0ptenmxagar9s",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}