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Related Experiment Video

Updated: Jun 11, 2026

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas
09:04

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Published on: September 5, 2011

Serial versus Once-Only Cervical Length Screening in Twin Pregnancies.

Moti Gulersen1,2, Frank Jackson3, Matthew Justin Blitz2,3

  • 1Sidney Kimmel Medical College of Thomas Jefferson University, Department of Obstetrics and Gynecology, Pennsylvania, United States, Philadelphia.

American Journal of Perinatology
|June 9, 2026
PubMed
Summary

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This summary is machine-generated.

Serial transvaginal ultrasound (TVU) cervical length (CL) screening in twin pregnancies detects more short cervices. This approach improves the sensitivity of cervical length screening for predicting preterm birth in twin gestations.

Area of Science:

  • Maternal-Fetal Medicine
  • Obstetrics
  • Perinatology

Background:

  • Twin pregnancies face higher risks of preterm birth.
  • Cervical length (CL) screening via transvaginal ultrasound (TVU) is used to predict preterm birth (PTB).
  • The optimal protocol for CL screening in twin pregnancies remains under investigation.

Purpose of the Study:

  • To compare the impact of serial versus once-only TVU CL screening on PTB prediction in twin pregnancies.
  • To evaluate the diagnostic performance of different CL screening strategies.

Main Methods:

  • Retrospective cohort study of 1,917 twin pregnancies undergoing TVU CL screening between 16 0/7 and 23 6/7 weeks' gestation.
  • Stratified analysis into serial CL screening (≥2 assessments) versus once-only CL screening (1 assessment).

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  • Calculated sensitivity, specificity, PPV, and NPV for CL thresholds ≤25 mm and ≤30 mm in predicting PTB (<34, <32, <28 weeks).

    • Main Results:

    • Serial CL screening identified a significantly higher incidence of short CL (≤25 mm) compared to once-only screening (12.6% vs. 0.9%, P <0.001).
    • Sensitivity for predicting PTB using a CL ≤25 mm threshold was substantially higher with serial screening across all gestational age cut-offs.
    • For PTB <34 weeks, sensitivity was 27.9% for serial vs. 4.2% for once-only screening.

    Conclusions:

    • Serial TVU CL screening in twin pregnancies is more effective in identifying short cervices.
    • Serial CL screening demonstrates superior sensitivity for predicting PTB in twin gestations.
    • Consideration of serial TVU CL screening from 16 0/7 to 23 6/7 weeks is recommended for twin pregnancies.