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Published on: September 5, 2011
Prediction of spontaneous preterm birth in asymptomatic twin pregnancies using the change in cervical length over
Nathan S Fox1, Andrei Rebarber, Chad K Klauser
1Carnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA. nfox@mfmnyc.com
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 > or = 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 (< or = 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.
