Use of cervical length, measured by transvaginal sonography at 22 to 26 weeks, as a predictor of preterm labour in twin pregnancy

Authors

  • Ricky Saini Department of Obstetrics and Gynecology, Command Hospital Air Force, Bangalore, India
  • Reena Yadav Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
  • B. Pathak Department of Obstetrics and Gynecology, Command Hospital Air Force, Bangalore, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20183758

Keywords:

Delivery, Gestation, Pregnancy, Preterm, Twin, Transvaginal sonography

Abstract

Background: Preterm labour and delivery contributes significantly to perinatal morbidity and mortality in twin gestation. Measurement of cervical length during antenatal period and subsequent follow up may identify women at risk for preterm labour.  The purpose of this study was to determine if measurement of cervical length at 22 to 26 weeks can be used as a predictor of preterm labour in twin pregnancy.

Methods: This prospective observational study was carried out in 50 women with twin gestation in a tertiary care teaching hospital. Cervical length was measured using transvaginal sonography and repeated every four weeks till delivery. Cervical length of ≤30 mm was taken as short cervix and delivery before 37 weeks was taken as preterm delivery.

Results: Total of 18 out of 50 women (36%) delivered between 32 to 34 weeks, 14 out of 50 (28%) delivered between 34 to 37 weeks, 7 out of 50 (14%) delivered at less than 32 weeks. Therefore, total preterm deliveries at less than 37 weeks were 78%. Total 11 out of 50 (22%) delivered at term i.e. at more than 37weeks. In women, who had short cervical length (≤ 30 mm) at the time of presentation, 14 out of 37 (38 %) delivered between 30 to 34 weeks, 12 out of 37 (32 %) women delivered between 34 to 37 weeks, 5 out of 37 (14%) delivered at ≤ 30 weeks. Rest 6 out of 37 (16 %) delivered after 37 weeks.

Conclusions: Short cervical length of ≤30 mm on transvaginal sonography at 22-26 weeks of gestation in twin pregnancy may be used as a screening tool in prediction of preterm labour in asymptomatic twin pregnancy.

References

Agustin Conde-Agudelo A, Romero R, Hassan SS, Yeo L. Transvaginal sonographic cervical length for the prediction of spontaneous preterm birth in twin pregnancies: a systematic review and metanalysis. Am J Obstet Gynecol. 2010;203(2):128.

Goldenberg RL, Iams JD, Miodovnik M, Van Dorsten JP, Thurnau G, Bottoms S et al. The preterm prediction study: risk factors in twin gestations. National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network. Am J Obstet Gynecol. 1996;175:1047-53.

Crane JMG, Van den Hof F, Armson BA, Liston R. Transvaginal ultrasound in the prediction of preterm delivery: Singleton and twin gestations. Obstet Gynecol. 1997;90:357-63.

Yang JH, Kuhlman K, Daly S, Berghella V. Prediction of preterm birth by second trimester cervical sonography in twin pregnancies. Ultrasound Obstet Gynecol. 2000;15:288-91.

Guzman ER, Walters C, O'Reilly-Green C, Kinzler WL, Waldron R, Nigam J et al. Use of cervical ultrasonography in prediction of spontaneous preterm birth in twin gestations. Am J Obstet Gynecol. 2000;183:1103-7.

Vayssiere C, Favre R, Audibert F, Chauvet MP, Gaucherand P, Tardif et al. Cervical length and funneling at 22 and 27 weeks to predict spontaneous birth before 32 weeks in twin pregnancies: a French prospective multicenter study. Am J Obstet Gynecol. 2002;187:1596-604.

Sperling L, Kiil C, Larsen LU, Qvist I, Bach D, Wojdemann K, et al. How to identify twins at low risk of spontaneous preterm delivery. Ultrasound Obstet Gynecol. 2005;26:138-44.

Lim AC, Hegeman MA, Huis In 'T Veld MA, Opmeer BC, Bruinse HW, Mol BW. Cervical length measurement for the prediction of preterm birth in multiple pregnancies: a systematic review and bivariate meta-analysis. Ultrasound Obstet Gynecol. 2011;38(1):10-7.

Gibson JL, Macara LM, Owen P, Young D, Macauley J, Mackenzie F. Prediction of preterm delivery in twin pregnancy: a prospective, observational study of cervical length and fetal fibronectin testing. Ultrasound Obstet Gynecol. 2004; 3(6):561-6.

Skentou C, Souka AP, To MS, Liao AW, Nicolaides KH. Prediction of preterm delivery in twins by cervical assessment at 23 weeks. Ultrasound Obstet Gynecol. 2001;17:7-10.

Downloads

Published

2018-08-27

Issue

Section

Original Research Articles