Prediction of spontaneous preterm birth in asymptomatic twin pregnancies using the change in cervical length over time
Presented as a poster at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine, San Diego, CA, Jan. 26-31, 2009.
Received 22 May 2009; received in revised form 17 July 2009; accepted 10 September 2009. published online 21 October 2009.
Objective
We sought to evaluate the change in cervical length (CL) as a predictor of preterm birth in asymptomatic twin pregnancies.
Study Design
We studied a historical cohort of 121 twin pregnancies with CL testing between 18-24 weeks who had a follow-up CL 2-6 weeks after the initial CL.
Results
A total of 19 patients had their CL decrease by ≥20% (shortened CL group) and 102 patients' CL decreased by less, or not at all (stable CL group). The shortened CL group had a significantly higher rate of spontaneous preterm birth <28 weeks, <30 weeks, <32 weeks, and <34 weeks. This remained true even when excluding patients with a short CL (≤25 mm) on the repeated CL.
Conclusion
In twin pregnancies, a CL that decreases by 20% over 2 measurements is a significant predictor of very preterm birth, even in the setting of a normal CL. Serial CL measurements should be considered in twin pregnancies, starting <24 weeks.
aCarnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY
bDepartment of Obstetrics and Gynecology, Metropolitan Hospital Center, New York, NY
Reprints: Nathan S. Fox, MD, Maternal Fetal Medicine Associates, PLLC, 70 E. 90 St., New York, NY 10128
Cite this article as: Fox NS, Rebarber A, Klauser CK, et al. Prediction of spontaneous preterm birth in asymptomatic twin pregnancies using the change in cervical length over time. Am J Obstet Gynecol 2010;202:155.e1-4.
ABSTRACT