Prevention of preterm birth in multiples.

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics
• Perinatology

Background:

• Multifetal pregnancies have a higher risk of preterm delivery.
• Current management strategies for preventing early birth in these pregnancies lack consensus.

Purpose of the Study:

• To review contemporary findings on interventions for preterm birth prevention in multifetal gestations.
• To address the controversial topic of managing high-risk pregnancies to reduce early delivery.

Main Methods:

• Systematic review of recent literature on preterm birth prevention in multifetal pregnancies.
• Analysis of evidence for interventions including cerclage, cervical pessary, and progesterone supplementation.

Main Results:

• Cerclage indicated by examination is effective in reducing preterm birth in twin pregnancies.
• Cervical pessary may benefit patients with a short cervix or history of threatened preterm labor.
• Progesterone supplementation alone is not beneficial for multifetal gestation but may help in cases with prior singleton preterm birth.

Conclusions:

• Interventions for preterm birth prevention in multiple gestations require further investigation.
• More data is needed to establish consensus on managing this high-risk obstetric population.