title: Emergency cervical cerclage after miscarriage of the first fetus in dichorionic twin pregnancies: obstetric and neonatal outcomes of delayed delivery interval.
abstract: OBJECTIVE
  To study the effectiveness of emergency cervical cerclage in order to delay the delivery interval after miscarriage of the first fetus in dichorionic twin pregnancies.
  
  
  METHODS
  Dichorionic twin pregnancies after miscarriage of the first fetus (<24 weeks) were exclusively included in the present analysis. Prolongation of delivery interval was managed with additional emergency cervical cerclage in the already initiated tocolytic therapy. Obstetric outcomes (cervical dilatation, gestational age at delivery of the first twin, interval between miscarriage and delivery of the second fetus) and neonatal outcomes [neonatal birth weight, Apgar score in the first and fifth minute, admission to Neonatal Intensive Care Unit (NICU)] of the second twin were analyzed.
  
  
  RESULTS
  Five cases of dichorionic twin pregnancies were included in our study. Cervical dilatation (mean ± SD) at admission time was 3.7 ± 1.4 cm. The gestational week at delivery of the first twin was 20.6 ± 2.6. The median delivery interval was 72 days and the maximum 121 days. Mean gestational age at delivery of the second twin was 28.8 ± 7.2 weeks and mean birth weight 1,772.5 ± 742 g. The rate of live birth was 80 %, while NICU admission was demanded in 75 % of the live births. All neonates discharged from NICU remained alive after 1 month of life.
  
  
  CONCLUSIONS
  The present study demonstrated beneficial effect concerning obstetric and neonatal outcomes of the second twin after performing emergency cervical cerclage to postpone the delivery interval in premature dichorionic twin pregnancies.
authors.affiliation: 4th Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 49 Konstantinoupoleos str, 54642, Thessaloniki, Greece. petustam@mail.gr
authors.forename: Stamatios
authors.initials: S
authors.lastname: Petousis
authors.forename: Antonios
authors.initials: A
authors.lastname: Goutzioulis
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Margioula-Siarkou
authors.forename: Taxiarchis
authors.initials: T
authors.lastname: Katsamagkas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kalogiannidis
authors.forename: Theodoros
authors.initials: T
authors.lastname: Agorastos
mesh_terms: D000022:Abortion, Spontaneous / Q000517:prevention & control*; D000328:Adult; D023802:Cerclage, Cervical; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D047928:Premature Birth / Q000517:prevention & control*; D012189:Retrospective Studies; D014427:Twins