Cervical Length as a Predictor of Latency Interval in Twin Pregnancies With Preterm Prelabor Rupture of Membranes [35H]

AbstractThe 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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Prediction of spontaneous preterm birth in asymptomatic twin pregnancies with the use of combined fetal fibronectin and cervical length

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.06.018 ◽

2009 ◽

Vol 201 (3) ◽

pp. 313.e1-313.e5 ◽

Cited By ~ 33

Author(s):

Nathan S. Fox ◽

Daniel H. Saltzman ◽

Chad K. Klauser ◽

Danielle Peress ◽

Christina V. Gutierrez ◽

...

Keyword(s):

Preterm Birth ◽

Cervical Length ◽

Spontaneous Preterm Birth ◽

Fetal Fibronectin ◽

Twin Pregnancies

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516: Positive fetal fibronectin in the setting of a normal cervical length in asymptomatic patients with twin pregnancies: what is the significance?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.10.535 ◽

2011 ◽

Vol 204 (1) ◽

pp. S206

Author(s):

Nathan Fox ◽

Andrei Rebarber ◽

Ashley Roman ◽

Chad Klauser ◽

Daniel Saltzman

Keyword(s):

Cervical Length ◽

Fetal Fibronectin ◽

Asymptomatic Patients ◽

Twin Pregnancies

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VP52.23: Cervical elastography in twin pregnancies with cervical length above 25mm at second trimester for prediction of preterm birth

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.23240 ◽

2020 ◽

Vol 56 (S1) ◽

pp. 300-301

Author(s):

H. Seol ◽

S. Pyeon ◽

H. Park ◽

H. Kwon ◽

J. Kwon ◽

...

Keyword(s):

Preterm Birth ◽

Cervical Length ◽

Second Trimester ◽

Twin Pregnancies

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Cervical Length as a Predictor of Preterm Delivery in an Unselected Cohort of Women with Twin Pregnancies

American Journal of Perinatology ◽

10.1055/s-0038-1676484 ◽

2018 ◽

Vol 36 (12) ◽

pp. 1288-1294 ◽

Cited By ~ 1

Author(s):

Clifton O. Brock ◽

Leslie A. Moroz ◽

Cynthia Gyamfi-Bannerman

Keyword(s):

Preterm Delivery ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Cervical Length ◽

Prospective Data ◽

Spontaneous Preterm Delivery ◽

False Discovery ◽

Twin Pregnancies ◽

Unselected Cohort

Objective To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. Study Design This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and 24 weeks. Prediction thresholds were determined using a false discovery rate of 10%. The risk of SPTD was compared with previously published, prospective data from a meta-analysis. Results A total of 1,228 women were included. SPTD occurred prior to 35 weeks in 232 (18.9%), 126 (10.3%), and 24 (2.0%) women prior to 35, 32, and 28 weeks. TVCL was most predictive at 22 weeks (area under the curve = 0.67). TVCL thresholds for predicting SPTD prior to 35, 32, and 28 weeks were 3.1, 3.0, and 2.9 cm. Compared with a previous meta-analysis, the risk of SPTD < 34, 32, and 28 weeks was lower (positive likelihood ratio 9.0 vs. 5.4, 10.1 vs. 5.9, and 9.6 vs. 4.3). Conclusion TVCL is modestly predictive of SPTD in twin gestations. Compared with previous prospective studies, this cohort has lower risk of SPTD at similar TVCLs.

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OP07.03: First trimester assessment of cervical length as a predictor of preterm birth in IVF/ICSI twin pregnancies

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.19445 ◽

2018 ◽

Vol 52 ◽

pp. 82-83

Author(s):

M. Aboulghar ◽

Y. El Faisal ◽

A. Kamel ◽

Y. Eslam

Keyword(s):

Preterm Birth ◽

First Trimester ◽

Cervical Length ◽

Twin Pregnancies

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P29.09: The use of long-term indomethacin stabilises cervical length in twin pregnancies

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.18297 ◽

2017 ◽

Vol 50 ◽

pp. 252-252

Author(s):

A.M. Shannon ◽

S. Crimmins ◽

J. Kopelman ◽

C. Harman ◽

O.M. Turan

Keyword(s):

Cervical Length ◽

Twin Pregnancies

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Vaginal Sonography of the Cervix for the Prediction of “Time to Delivery” in ART Twins Gestations

Twin Research ◽

10.1375/twin.5.4.255 ◽

2002 ◽

Vol 5 (4) ◽

pp. 255-259

Author(s):

Adrian Shulman ◽

Eric Jauniaux ◽

Anna Holmes ◽

Shlomo Maschiach ◽

Ron Maymon

Keyword(s):

Cervical Length ◽

Current Data ◽

Transvaginal Sonography ◽

Time Interval ◽

Important Indicator ◽

Vaginal Sonography ◽

The Mean ◽

Routine Antenatal Care ◽

Time To Delivery ◽

Twin Pregnancies

AbstractThe present study aimed to determine a reliable tool to estimate the interval time to delivery in assisted conception twin pregnancies. Mid-gestation cervical length was prospectively measured using transvaginal sonography (TVS) during routine antenatal care. Fifty-seven of 101 suitable women were longitudinally followed and two TVS measurements of their cervical length were obtained, first at approximately 24 weeks gestation and then at approximately 27 weeks gestation. The mean cervical length decreased from 37 ± 12mm at first measurement to 34 ± 11mm at the second one. A linear regression model was found between the time interval of the first (R = 0.656, p < 0.001) and the second (R = 0.435, p < 0.001) assessments and the week of delivery. The current data confirm that the length of the preserved segment of the cervix is an important indicator of its competence. A simple equation using the cervical length (mm) divided by 3 can predict mid gestation scan-to-delivery interval in twin gestation.

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Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0302 ◽

2018 ◽

Vol 46 (7) ◽

pp. 780-785 ◽

Cited By ~ 1

Author(s):

Su Jin Sung ◽

Seung Mi Lee ◽

Sohee Oh ◽

Joo Hee Choi ◽

Jee Yoon Park ◽

...

Keyword(s):

Risk Factor ◽

Cesarean Section ◽

Cervical Length ◽

Spontaneous Preterm Birth ◽

Short Cervix ◽

Trial Of Labor ◽

Nulliparous Women ◽

Increased Risk ◽

Confounding Variables ◽

Twin Pregnancies

Abstract Objective: It is well known that a short cervix at mid-pregnancy is a risk factor for spontaneous preterm birth in both singleton and twin gestations. Recent evidence also suggests that a long cervix at mid-pregnancy is a predictor of the risk of cesarean section (C/S) in singleton gestation. The purpose of this study was to determine whether a long cervix at mid-pregnancy was associated with an increased risk of C/S in women with twin pregnancies. Methods: We enrolled 746 women pregnant with twins whose cervical length was measured by trans-vaginal ultrasonography at a mean of 22 weeks of gestation and who delivered in our institution. Cases with a short cervix [cervical length (CL) <15 mm] were excluded. Cases were divided into four groups according to the quartile of CL. Results: The rate of C/S increased according to the quartile of CL (47% in the 1st quartile, 51% in the 2nd quartile, 56% in the 3rd quartile and 62% in the 4th quartile, P<0.005, χ2 for trend). CL was an independent risk factor for C/S even after adjustment for confounding variables. When confining analysis to women who delivered after a trial of labor (n=418), to nulliparous women (n=633) or to those who delivered at late preterm or full term (n=666), the rate of C/S also increased according to the quartile of CL, and the relationship between CL and the risk of C/S remained significant after adjustment in each group. Conclusion: In women pregnant with twins, long CL at mid-pregnancy was a risk factor for C/S.

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