Authors: Shapiro, J.L.; Kung, R.; Barrett, J.F.R.

Source: Twin Research, Volume 3, Number 4, 1 December 2000 , pp. 213-216(4)

Publisher: Australian Academic Press

Abstract:

The aim of this study was to determine the predictive value of cervical lengthas a risk factor for spontaneous pre-term birth in twin gestations. Aretrospective chart review was carried out on patients with twin pregnanciesreferred to our multiples' clinic. Cervical length was measured bytransvaginal ultrasonography. Patients with an indicated pre-term deliveryor intervention were excluded from the analysis. Outcomes included pretermdelivery < 28 and < 35 weeks gestation. After extracting the data,2 × 4 tables were constructed. Likelihood ratios were then generated forcervical lengths ≤ 2.0 cm, ≤ 2.5 cm, ≤ 3.0 cm, and > 3.0 cm. Becauseof the limited number of measurements taken < 25 weeks gestation, we electedto collapse the tables, thereby achieving more meaningful results. Formeasurements taken before 30 weeks gestation, a shorter cervix did predictdelivery < 28 weeks gestation (likelihood ratios for cervical lengths ≤2.0 cm, ≤ 2.5 cm, ≤ 3.0 cm, and > 3.0 cm were 4.43, 1.94, 0.97, and 1.02,respectively). The probability of preterm delivery < 35 weeks gestationincreased with decreasing cervical length (likelihood ratios for cervical length≤ 2.0 cm, ≤ 2.5 cm, ≤ 3.0 cm, and > 3.0 cm were 2.58, 1.66, 1.38, and0.81, respectively). A shorter cervix measured before 30 weeks gestation was astronger predictor of preterm delivery < 28 weeks compared to < 35 weeksgestation. Cervical length was not predictive of preterm delivery if measured after30 weeks. Cervical length is predictive of preterm delivery < 28 weeks and <35 weeks gestation when measured before 30 weeks gestation. No trend was seen whenmeasured after 30 weeks gestation. A prospective study is currently underway toconfirm these results.

Keywords: pre-term labor; twins; cervical length; ultrasonography

Document Type: Research article

DOI: http://dx.doi.org/10.1375/136905200320565175

Affiliations: 1: Department of Obstetrics and Gynecology, Sunnybrook and Women's College Health Sciences Center, University of Toronto, Toronto, Ontario, Canada

Publication date: 2000-12-01

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