American Journal of Obstetrics & Gynecology
Volume 202, Issue 2 , Pages 155.e1-155.e4, February 2010

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.

  • Nathan S. Fox, MD

      Affiliations

    • Carnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY
    • Corresponding Author InformationReprints: Nathan S. Fox, MD, Maternal Fetal Medicine Associates, PLLC, 70 E. 90 St., New York, NY 10128
    • ,
  • Andrei Rebarber, MD

      Affiliations

    • Carnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY
    • ,
  • Chad K. Klauser, MD

      Affiliations

    • Carnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY
    • ,
  • Danielle Peress, BS

      Affiliations

    • Carnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY
    • ,
  • Christine V. Gutierrez, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Metropolitan Hospital Center, New York, NY
    • ,
  • Daniel H. Saltzman, MD

      Affiliations

    • Carnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY

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.

Key words: cervical length, prediction, preterm birth, twins

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 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.

PII: S0002-9378(09)01011-4

doi:10.1016/j.ajog.2009.09.004

American Journal of Obstetrics & Gynecology
Volume 202, Issue 2 , Pages 155.e1-155.e4, February 2010

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