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Maternal-Fetal MedicineSociety
SG-003GuidelinePreterm birth

Preterm birth: prevention and management

Indications for cervical length measurement, progesterone prophylaxis, cerclage criteria, tocolysis and corticosteroid prophylaxis.

Version 2.441 pagesUpdated 12 November 2025Perinatology Working Group

Key recommendations

  • Cervical length measurement at 18–24 weeks with a history of preterm birth
  • Vaginal progesterone when cervical length is ≤ 25 mm
  • Corticosteroids at 24–34 weeks when preterm birth is anticipated
  • Magnesium sulphate for neuroprotection below 32 weeks

The document covers primary and secondary prevention as well as intrapartum management.

Cerclage

Indications fall into three categories: history-indicated, ultrasound-indicated and examination-indicated. Separate criteria are defined for each.

Transfer

Where birth is anticipated between 22 and 32 weeks, transfer to a tertiary centre before delivery is recommended — in-utero transfer is preferable to neonatal transfer.

Note: A guideline is a recommendation and does not replace the clinician's professional judgement in an individual case. Departing from it is acceptable where the reasoning is documented.