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Published on: September 5, 2011
[PREVENTION OF PRETERM BIRTH IN TWINS WITH SHORT MID-TRIMESTER CERVICAL LENGTH LESS THAN 25MM -COMBINED TREATMENT
Ariel Zimerman1, Ron Maymon1, Yfat Viner1
1Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center affiliated with the Tel Aviv University, Sacker Faculty of Medicine, Zerifin, Israel.
Background:
Twin pregnancies with short mid-trimester cervical length have a high rate of preterm births.
Objectives:
To compare combined treatment of Arabin cerclage pessary, and intravaginal micronized progesterone to conservative treatment for the prevention of preterm births in twins pregnancies with short cervical length in second trimester of pregnancy.
Methods:
A retrospective study that compared twin pregnancies with short ≤25mm cervix in second trimester 16-28 gestational weeks treated with combined treatment of Arabin cervical pessary and intravaginal micronized progesterone 200mg TID to a control group with conservative treatment for the prevention of preterm.
Results:
The treatment group included 32 patients and the control group 26 patients. Average week at admission was 23 ± 2.2 vs 25 ±3.1 weeks, average cervical length at admission 14.1 ± 2.2 mm vs 13 ±2.1 mm respectively. Average week of delivery 34.4 ±3.9 vs. 33.4 ±4.1, p=0.6 and incidence of delivery ≤28weeks was 9.4% vs. 34% p=0.04.
Conclusions:
The treatment group had a lower incidence of preterm birth before 28 weeks. Further prospective studies are needed to assess preterm birth prevention treatments efficacy and the use of Arabin cervical pessary in twins.
