CerviLenz

The new ACOG Practice Bulletin No. 130 convinced me that progesterone can prevent preterm birth, and in the case of short cervix, it’s vaginal progesterone that reduces risks and improves neonatal outcomes. That’s why I decided to start screening and I chose the CerviLenz device as the screening modality, reserving transvaginal ultrasound as the diagnostic.

The CerviLenz device is easy to use, it’s reproducible, and it’s very reliable. It’s just placing in a speculum and measuring. It’s very easy. It’s quick and, in my practice, it’s certainly something that’s more cost effective and better for the patient flow in our office. I also see that this is an opportunity for a screening test that can be done by a nurse practitioner.

The CerviLenz measuring device has been a very welcomed addition to our OB care. It doesn’t replace my diagnostic test, it gives me the direction on how to get to my diagnostic test - and that’s what a screening test should do. It is working very well in our practice.

I started using CerviLenz to see if it would be helpful in identifying patients for progesterone therapy.  I found it very easy to use and very helpful, especially to give a baseline measurement for primiparous women. 

The new SMFM Clinical Guideline makes a very compelling case for cervical length screening of all singleton pregnancies. Now that we know vaginal progesterone therapy reduces preterm birth by nearly 50% for patients with a short cervix, we must find and treat them. Saying a cervix is “Long, thick, and closed” just isn’t good enough anymore.

The good news is that the Cervilenz device allows your practice to start screening today. It’s a quick, easy, and accurate procedure during a routine prenatal visit to identify patients who may have a short cervix. If her Cervilenz measurement is less than 30 mm. refer her for an indicated transvaginal ultrasound because she may be a candidate for vaginal progesterone therapy. Saving just one family from a potentially tragic outcome or just the cost of one long NICU stay will make screening well worth it!

Our clinic is very busy and we do a lot of TVU cervical length assessments. Having another tool to get an immediate, objective cervical length assessment can be very helpful, especially since it can be used by nurses and midwives who are not trained to use transvaginal ultrasound. CerviLenz can be used in conjunction with TVU to help diagnose preterm labor or to monitor patients at risk for preterm delivery: as long as she stays above 25 mm on CerviLenz, keep using it; if her CerviLenz measurement is less than 25 mm, refer her for TVU. It’s easy to use and can really improve efficiency in a busy clinic or practice.

I started using CerviLenz in the hospital to triage patients with preterm labor symptoms because I was impressed with Dr. Burwick’s research comparing CerviLenz to fFN.  Just as that study suggested, CerviLenz has had a very positive impact on efficiency and cost.  We’ve cut both triage time and fFN analysis in half using CerviLenz for our initial assessment. 

Now I’m also using CerviLenz in my office because cervical length is such an important diagnostic data point for preterm birth risk assessment.  All of my patients get TVU cervical length at their anatomy scan mid-gestation.  With CerviLenz, I’m measuring cervical length again around 22-24 weeks to make sure I’m identifying all the high risk patients and can change their management as appropriate.  For high risk patients, it’s also great to be able to monitor for cervical shortening during regular office visits with CerviLenz rather than sending everyone out for TVUs every week or two.  CerviLenz is definitely adding clinical value to my practice and benefits my patients.