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Updated: Jul 12, 2025

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Screening and Prevention of Preterm Birth in Twin Pregnancies

Amanda Roman1

  • 1Obstetrics and Gynecology Department, Maternal Fetal Medicine Division, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.

Clinical Obstetrics and Gynecology
|November 1, 2023
PubMed

Twins represent 3.2% of all live births. However, they account for 20% of all preterm deliveries, 60% delivering <37 weeks, 10.7% <32 weeks, and 5 times higher risk of infant death. Risk factors for preterm birth (PTB) include the history of preterm delivery, monochorionic twins, short cervical length, and cervical surgery. Transvaginal cervical length <24 weeks is the best tool to predict PTB. Only vaginal progesterone in women with transvaginal cervical length <25 mm and physical exam indicated cerclage in women with cervical dilation >1 cm have shown a significant decrease in PTB and improvement in neonatal outcomes.

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