Cervical Length at 23 Weeks in Twins in Predicting Spontaneous Preterm Delivery

Souka, Athena P.; Heath, V.; Flint, Sarah; Sevastopoulou, I.; Nicolaides, Kypros

doi:10.1097/00006250-199909000-00024

Cited by 43 publications

(68 citation statements)

References 17 publications

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“…We could observe an increase in risk for preterm delivery before 34 weeks to 50% using 25 mm as cut-off in our population. For the same cut-off, Souka et al described that of 45% delivered before 32 weeks of gestation (Souka et al, 1999). Yang et al examined 65 twin pregnancies using translabial or transvaginal ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

et al. 2008

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The objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

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Section: Discussionmentioning

confidence: 99%

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

et al. 2008

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“…A large number of prospective studies [20][21][22][23][24][25][26][27][28][29][30] have shown the predictive value of midtrimester cervical length measurement in twin pregnancies; these data were collected in two large meta-analyses. The first meta-analysis included 21 studies, 16 in asymptomatic women and only 5 in symptomatic women; the collected data included 3,523 women.…”

Section: Prediction Of Preterm Birthmentioning

confidence: 99%

Twin and Preterm Labor: Prediction and Treatment

Aboulghar

Islam

2013

Curr Obstet Gynecol Rep

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Twin pregnancies are increasing. Preterm birth is a major health problem with high incidence all over the world. It is known to have a higher incidence in twin pregnancies as well as being higher in IVF/ICSI pregnancies. Prediction of preterm birth in twins through transvaginal cervical length measurement and vaginal fetal fibronectin measurement are good and well-documented methods. However, this could not be applied to IVF pregnancies. Prevention of preterm birth by administration of vaginal natural progesterone or IM synthetic progesterone injections is not effective in twins. The situation was similar with administration of progesterone to IVF twin pregnancies. Prophylactic cerclage for prevention of preterm birth in twins resulted in an increase of the incidence of preterm birth. Tocolytics also are ineffective, although nifedipine may have a role in treatment of threatened preterm birth in twins.

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“…En un estudio realizado en los Estados Unidos se observó que el 57,4% de los niños producto de embarazos gemelares nació antes de las 37 semanas versus el 10,4% de las gestaciones únicas (15). Predicción de riesgo: Existe buena evidencia avalando que la detección del acortamiento cervical por examen digital o por medición ultrasonográfi-ca, es un buen predictor del riesgo de parto prematuro (16,17,18). Existe también buena evidencia de que la presencia cervicovaginal de fibronectina fetal (FF) predice un mayor riesgo de parto prematuro (19,20,21), sin embargo, no existen estudios intervencionales bien diseñados para indicar la incorporación del tamizaje rutinario de FF al manejo prenatal de embarazos gemelares.…”

Section: Parto Prematurounclassified

Pautas De Manejo Clínico De Embarazos Gemelares

Becker

2009

Rev. chil. obstet. ginecol.

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RESUMENEl embarazo gemelar conlleva un elevado riesgo de morbilidad y mortalidad perinatal. Teniendo el control prenatal una reconocida utilidad en disminuir la morbimortalidad perinatal, decidimos elaborar pautas de manejo clínico, basadas en evidencia, que orienten el seguimiento prenatal de embarazos gemelares. Realizamos una revisión de las publicaciones recientes, guías clínicas y textos clásicos de obstetricia obteniendo la información necesaria. Presentamos un listado de las recomendaciones y la calidad de evidencia que las sustenta, respecto de seis ítems: a. Reproducción asistida; b. Diagnóstico de embarazo gemelar; c. Manejo general del embarazo gemelar; d. Parto prematuro; e. Complicaciones específicas de embarazos gemelares; y f. Momento de interrupción y manejo del trabajo de parto. PALABRAS CLAVE: Embarazo múltiple, embarazo gemelar, guías clínicas SUMMARYMultiple pregnancy has high risk of perinatal morbidity and mortality. Since antenatal care has been demonstrated as a useful tool in reducing perinatal risk, we decided to elaborate evidence based clinical guidelines, to facilitate antenatal care of women carrying multiple pregnancies. We reviewed recent publications, clinical guidelines and text books to obtain necessary information. Here we present a list of recommendations, and the quality of supporting evidence, about six items: a. Assisted reproduction; b. Diagnosis of multiple pregnancy; c. General care of multiple pregnancy; d. Preterm Labor; e. Specific complications of multiple pregnancy; f. Timing of delivery and labor management. KEY WORDS: Multiple pregnancy, twin pregnancy, guidelines INTRODUCCIÓNLa incidencia de embarazos múltiples ha aumentado dramáticamente en las últimas décadas en los países desarrollados, desde 1 por 100 nacidos vivos a 1 por 70 nacidos vivos, con un aumento de un 40% en la tasa de embarazos gemelares y un aumento de 3 a 4 veces en embarazos múlti-ples de alto orden. Este aumento en el número de embarazos múltiples es atribuible en mayor parte a la utilización de técnicas de reproducción asistida, pero también se explica por un aumento en la edad materna, ya que existe asociación entre la edad materna y la tasa de gestaciones múltiples concebidas espontáneamente (1).El embarazo múltiple es un embarazo de alto riesgo fetal, pues tiene, entre otros problemas, mayor incidencia de prematurez, restricción del crecimiento fetal, malformaciones congénitas y muerte fetal in útero comparado con las gestaciones úni-cas. Existen además, complicaciones propias del embarazo gemelar como: crecimiento discordante, muerte in útero de alguno de los gemelos, síndrome de transfusión feto-fetal, gemelos monoamnióticos

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Cervical Length at 23 Weeks in Twins in Predicting Spontaneous Preterm Delivery

Cited by 43 publications

References 17 publications

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

Twin and Preterm Labor: Prediction and Treatment

Pautas De Manejo Clínico De Embarazos Gemelares

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