Indications for Transvaginal Cervical Length Evaluation and fFN

• History of Uterine defect (septum, bicornuate, didelphys) with or without correction.

• History of pre-term delivery.

• History of PPROM.

• Multiple gestations.

• Suspected short cervix and/or funnel on transabdominal sono.

NOTE: A Fetal Fibronectin (fFN) is be obtained after 24weeks with each TVS. Generally, TVS and fFN collection continues at each visit to 32 weeks, however, may be continued up to 34 weeks if patient is symptomatic or by physician order.

There are other indications that may require a transvaginal ultrasound and fFN based on Physician/APN prior recommendations. Please read last Docs in EHR and recommendations on last AS report. Frequent indications that may or may not require TVS and fFN are listed below

• History of pre-term labor

• History of recurrent (3 or more) first trimester losses

• History of cervical surgery (LEEP, cone biopsy)

• Pre-term contractions

• Uterine myomas (Fibroids)

• Significant polyhydramnios (>30cm)

• Maternal collagen disorders (Marfan’s Syndrome, Ehlers-Danlos)