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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle length...
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Related Experiment Video

Updated: Jul 9, 2026

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators
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Preterm labor in twins and high-order multiples.

John P Elliott1

  • 1Phoenix Perinatal Associates, a Division of Obstetrix Medical Group of Phoenix, 1331 N. 75th Street, 275 Phoenix, AZ 85006, USA. john_elliott@obstetrix.com

Clinics in Perinatology
|December 8, 2007
PubMed
Summary

Preterm labor (PTL) is common in multiple gestations, necessitating early detection and management to prevent preterm delivery (PTD). All multiple gestations are considered at risk for PTL, requiring proactive clinical strategies for optimal pregnancy outcomes.

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Published on: September 5, 2011

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatology

Background:

  • Preterm labor (PTL) is a frequent complication in multiple gestations, often leading to preterm delivery (PTD).
  • Unlike singleton pregnancies, all multiple gestations are inherently at risk for PTL.
  • Effective management strategies are crucial for early PTL detection and prevention of PTD.

Purpose of the Study:

  • To outline management strategies for multiple gestations focusing on early PTL detection.
  • To emphasize the high-risk nature of PTL in multiple gestations.
  • To guide clinicians in optimizing pregnancy duration for favorable outcomes.

Main Methods:

  • Review of current clinical practices and literature regarding PTL in multiple gestations.
  • Emphasis on proactive risk identification for all multiple gestation patients.
  • Holistic patient management approach considering all factors influencing delivery timing.

Main Results:

  • Every multiple gestation pregnancy should be managed with the assumption of PTL risk.
  • PTL is a primary driver of PTD, but other factors also necessitate delivery.
  • Extending gestational age is a key goal when medically feasible.

Conclusions:

  • Proactive management and early PTL detection are essential in multiple gestations.
  • Recognizing diverse reasons for delivery beyond PTL is critical.
  • Individualized patient care aiming for the most advanced gestational age ensures optimal outcomes.