This is a recommended procedure from the Society of MFM and the American College of Obstetricians and Gynecologists to help determine a woman’s risk for preterm delivery.
Should be offered to all patients between 18-24 weeks.
Ensure patient has an empty bladder.
Prepare the cleaned probe using probe cover (Latex or Non-latex)
Obtain a sagittal, long-axis image of the entire cervix.
Remove probe until the image is blurs and then reinsert gently until the image clears (this ensure you are not using excessive pressure).
Enlarge image so that the cervix occupies two thirds of the screen.
Ensure both internal and external os are seen clearly.
Observe cervical length for 3 minutes.
Measure the cervical length along the endocervical canal between the internal and the external os.
Repeat this process to obtain 3 sets of images/measurements.
Apply fundal pressure then obtain another measurement.
On your report record your shortest best cervical length.
If the cervical length is less than 25mm:
First contact the appropriate doctor, second contact the MA in your office or appropriate MA to get the patient started on vaginal progesterone,
Next schedule the patient within 1 weeks with perinate for level 3, TV, and MFMC (this will be at the discretion of the hospital doc).
Call or ask the APN in the office to call the referring provider with the results and the plan of care. (Please keep in mind that only approximately 2/100 women will have a cervical length of less than 20mm, therefore this is a rare finding.)
If the initial cervical length is over 25mm no further cervical lengths are necessary
These measurements and follow ups are precise and should be followed exactly
You must use diagnosis code Z36.86 (screening cervical length for PTL) for billing for cervical length screening
Under the impression tab in AS there is a macro. Use the macro that you would normally use. Then hit enter and use the macro for either cervical length screening declined by patient or cervical length screening performed.
