Gestational age at cervical length measurement and preterm birth in twins

Objectives To estimate the risk of preterm delivery of twin pregnancies based upon sonographic cervical length measurement and gestational age at measurement. Methods Twin pregnancies that delivered between 1999 and 2005 and that underwent sonographic measurement of cervical length between 13 and 34...

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Bibliographic Details
Published in:	Ultrasound in obstetrics & gynecology Vol. 40; no. 1; pp. 81 - 86
Main Authors:	Ehsanipoor, R. M., Haydon, M. L., Lyons Gaffaney, C., Jolley, J. A., Petersen, R., Lagrew, D. C., Wing, D. A.
Format:	Journal Article
Language:	English
Published:	Chichester, UK John Wiley & Sons, Ltd 01-07-2012 Wiley Wiley Subscription Services, Inc
Subjects:	Adult Biological and medical sciences California - epidemiology cervical length Cervical Length Measurement - methods Cervix Uteri - diagnostic imaging Diseases of mother, fetus and pregnancy Female Gestational Age Gynecology. Andrology. Obstetrics Humans Infant, Newborn Logistic Models Medical sciences multiple gestation Obstetric Labor, Premature Pregnancy Pregnancy. Fetus. Placenta Premature Birth - diagnostic imaging Premature Birth - epidemiology preterm delivery Retrospective Studies Risk Factors transvaginal ultrasonography Twins Ultrasonography, Prenatal Sonography Multiple multiple gestation Pregnancy disorders Gynecology Premature delivery Length measurement Uterine cervix Obstetrics Gestational age Twin Pregnancy twins Prematurity Transvaginal route Length Echography cervical length transvaginal ultrasonography preterm delivery
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Summary:	Objectives To estimate the risk of preterm delivery of twin pregnancies based upon sonographic cervical length measurement and gestational age at measurement. Methods Twin pregnancies that delivered between 1999 and 2005 and that underwent sonographic measurement of cervical length between 13 and 34 + 6 weeks' gestation were identified and a retrospective review performed. Women with anomalous pregnancies, multifetal reduction, cerclage placement or medically indicated deliveries before 35 weeks were excluded. Logistic regression analysis was used to estimate the risk of preterm delivery before 35 weeks. Results A total of 561 women underwent 2975 sonographic cervical length measurements during the study period. The rate of preterm delivery before 35 weeks was 19.4%. The risk of delivery before 35 weeks decreased by approximately 5% for each additional mm of cervical length (odds ratio (OR) 0.95 (95% CI, 0.93–0.97); P < 0.001) and by approximately 6% for each additional week at which the cervical length was measured (OR 0.94 (95% CI, 0.92–0.96); P < 0.001). Conclusion The gestational age at which cervical length is measured is an important consideration when estimating the risk of spontaneous preterm birth in twins. The risk of preterm delivery is increased at earlier gestational ages and as cervical length decreases. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0960-7692 1469-0705
DOI:	10.1002/uog.10130