title: Routine cervical length in twins and perinatal outcomes.
abstract: A retrospective review of twin gestations was undertaken to evaluate whether routine cervical lengths (CLs) in such instances change pregnancy outcome. Data were collected from the ultrasound database and chart review. Exclusion criteria included twins reduced to singletons, twins not delivering at our institution, and incomplete information. Twin gestations with a CL were compared with those without a CL. Outcomes of interest included gestational age (GA) at delivery, preterm delivery (PTD), antepartum admissions, antepartum length of stay (LOS), cerclage placement, birthweight, neonatal intensive care unit admissions, and neonatal LOS. Two hundred sixty-two patients met inclusion criteria. Of those, 184 had CLs and 78 did not. Comparing the CL to the no-CL group, there were no differences with respect to GA at delivery (34.8 versus 35.3 weeks; p=0.35), antepartum admissions (32.1 versus 23.1%; p=0.16), cerclage placement (7.1 versus 1.3%; p=0.06), or tocolysis use (28.6 versus 21.8%; p=0.26). There was no difference between the two groups with respect to preterm labor (26 versus 19%; p=0.25), PTD < 28 weeks (8.2 versus 3.9%; p=0.21), PTD < 34 weeks (26.1 versus 25.6%; p=0.94), or PTD < 37 weeks (76.1 versus 70.5%; p=0.34). The only significant difference was antepartum LOS (34.5 versus 31.3 days; p< 0.001). There were no differences in neonatal outcomes. Routine CL did not improve perinatal outcome but increased maternal antepartum LOS.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gyamfi
authors.forename: Veronica
authors.initials: V
authors.lastname: Lerner
authors.forename: Ian
authors.initials: I
authors.lastname: Holzman
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Stone
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000706:statistics & numerical data; D002584:Cervix Uteri / Q000473:pathology*; D003955:Diagnostic Tests, Routine; D005260:Female; D005865:Gestational Age; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D009519:New York City / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014427:Twins; D002581:Uterine Cervical Incompetence / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology