Prediction of spontaneous preterm birth in asymptomatic twin pregnancies using the change in cervical length over time.
OBJECTIVE
We sought to evaluate the change in cervical length (CL) as a predictor of preterm birth in asymptomatic twin pregnancies.


METHODS
We studied a historical cohort of 121 twin pregnancies with CL testing between 18-24 weeks who had a follow-up CL 2-6 weeks after the initial CL.


RESULTS
A total of 19 patients had their CL decrease by > or = 20% (shortened CL group) and 102 patients' CL decreased by less, or not at all (stable CL group). The shortened CL group had a significantly higher rate of spontaneous preterm birth <28 weeks, <30 weeks, <32 weeks, and <34 weeks. This remained true even when excluding patients with a short CL (< or = 25 mm) on the repeated CL.


CONCLUSIONS
In twin pregnancies, a CL that decreases by 20% over 2 measurements is a significant predictor of very preterm birth, even in the setting of a normal CL. Serial CL measurements should be considered in twin pregnancies, starting <24 weeks.
Carnegie Hill Imaging for Women, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA. nfox@mfmnyc.com
Nathan S
NS
Fox
Andrei
A
Rebarber
Chad K
CK
Klauser
Danielle
D
Peress
Christine V
CV
Gutierrez
Daniel H
DH
Saltzman
D000328:Adult; D054791:Cervical Length Measurement; D015331:Cohort Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology*; D012306:Risk; D014427:Twins