Mid-Trimester Endovaginal Sonography in Women at High Risk for Spontaneous Preterm Birth

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Abstract
Preterm birth is the most important cause of infant morbidity and mortality and complicates 11% of all pregnancies in the United States.1 Most (80%) of these births result from either spontaneous labor or membrane rupture.2 Since the development of neonatal intensive care units, most neonatal deaths associated with prematurity occur in infants born at less than 32 weeks' gestation, but significant morbidities including sepsis, respiratory distress, and necrotizing enterocolitis do not abate until 35 weeks' gestation, after which neonatal outcomes are generally good.3,4 To date, a prior preterm birth is one of the strongest and most consistent predictors of prematurity, and the risk of recurrence is inversely proportional to the gestational age of the prior delivery.5,6