Twin Research and Human Genetics

Articles

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

Katharina Kleina1, Hubertus Gregora2, Kora Hirtenlehner-Ferbera3, Maria Stammler-Safara4, Armin Witta5, Andreas Hanslika6, Peter Hussleina7 and Elisabeth Krampla8 c1

a1 Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Austria.

a2 Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Austria.

a3 Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Austria.

a4 Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Austria.

a5 Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Austria.

a6 Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Austria.

a7 Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Austria.

a8 Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Austria. elisabeth.krampl@meduniwien.ac.at

Abstract

The objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%, p = .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159; p = .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

(Received March 14 2008)

(Accepted May 16 2008)

Keywords

  • preterm delivery;
  • twin pregnancy;
  • measurement of the cervical length

Correspondence:

c1 Address for correspondence: Elisabeth Krampl, Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18 – 20, A-1090 Vienna, Austria.

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