Advanced cervical dilatation and spontaneous preterm labor: a comparison between twin and singleton gestations

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics
• Perinatology

Background:

• Spontaneous preterm labor (SPTL) presents a significant challenge in managing pregnancies.
• Advanced cervical dilatation at presentation requires careful consideration of delivery timing and maternal-fetal outcomes.

Purpose of the Study:

• To compare the admission-to-delivery interval and immediate delivery rates in twin versus singleton gestations complicated by SPTL.
• To evaluate prolonged latency and antenatal corticosteroid completion in twin versus singleton pregnancies with SPTL.

Main Methods:

• Retrospective cohort study of pregnant women (24-34 weeks gestation) with advanced cervical dilatation (3-5 cm) and contractions.
• Comparison of delivery rates within 12 and 24 hours, prolonged latency, and betamethasone course completion between twin and singleton gestations.

Main Results:

• Overall delivery rates within 12 and 24 hours were similar for twins and singletons (47.8% and 59.4%, respectively).
• Prolonged latency (≥10 days) was significantly more frequent in twin gestations (40%) compared to singletons (15.9%; P=0.026).
• Women with twin gestations had a higher likelihood of completing a 2-dose betamethasone course (76%) versus singletons (47.7%; OR 3.5, P=0.022).

Conclusions:

• Approximately 60% of women with advanced cervical dilatation before 34 weeks deliver within 24 hours.
• Twin gestations complicated by SPTL demonstrate a trend towards prolonged latency and improved antenatal betamethasone completion compared to singletons.