Screening for preterm birth in twin pregnancies.

Area of Science:

• Obstetrics and Gynecology
• Perinatology
• Maternal-Fetal Medicine

Background:

• Twins constitute 3.2% of live births but account for 20% of preterm deliveries.
• Twin pregnancies carry a fivefold higher risk of early neonatal and infant mortality due to prematurity.
• Monochorionic twins face a greater risk of preterm delivery compared to dichorionic twins.

Purpose of the Study:

• To analyze the incidence and risk factors associated with preterm birth in twin pregnancies.
• To identify the most effective predictor for preterm delivery in twin gestations.

Main Methods:

• Review of twin birth data and associated prematurity risks.
• Analysis of risk factors including chorionicity, prior preterm birth, and cervical surgery.
• Evaluation of transvaginal cervical length as a predictive factor for preterm birth.

Main Results:

• 60% of twins are delivered before 37 weeks, and 10.7% before 32 weeks gestation.
• Transvaginal cervical length measurement before 24 weeks is the strongest predictor of preterm birth.
• History of preterm delivery and cervical surgery are additional risk factors.

Conclusions:

• Twin pregnancies are at high risk for preterm birth and related mortality.
• Transvaginal cervical length is a crucial independent predictor for timely intervention in preterm birth prevention for twins.