Transactions of the Twentieth Annual Meeting of the Society For Maternal-Fetal Medicine—ContinuedUse of cervical ultrasonography in prediction of spontaneous preterm birth in twin gestations☆
Section snippets
Material and methods
This prospective study involved 131 women with twin gestations who were longitudinally evaluated on 524 occasions with serial transvaginal ultrasonography and transfundal pressure between 15 and 28 weeks’ gestation. The study was undertaken in the antenatal testing unit at Saint Peter’s University Hospital, New Brunswick, NJ, between September 1993 and June 1999. At each examination the funnel width, funnel length, cervical length, percentage of funneling (considered to be Funnel length/[Funnel
Results
Table I depicts the maternal demographic data and obstetric history. Table II summarizes the pregnancy outcomes.Maternal age (y, median and range) 33.2 (18-46) Race (No.) White 87 (66.4%) Black 21 (16.0%) Hispanic 5 (3.8%) Other 17 (13.1%) Parity (No.) Nulliparous 73 (56%) Primiparous 33 (25%) Multiparous 25 (19%) History of spontaneous preterm delivery at 24-37 wk (No.) 11 (8.4%) History of second-trimester loss (No.) 5 (3.8%) Previous cerclage (No.) 2 (1.5%)
Comment
Other studies have assessed cervical ultrasonography as a screening test for spontaneous preterm birth in twin gestations. Imseis et al3 measured cervical length between 24 and 26 weeks’ gestation in 85 twin gestations. Because many of their patients required some form of intervention, they focused on identification of a subset of twin gestations at low risk for delivery at <34 weeks’ gestation. They established a cervical length cutoff value of >3.5 cm for prediction of delivery at ≥34 weeks’
Acknowledgements
We gratefully acknowledge Cande V. Ananth, PhD, MPH, for the expertise in research design and statistical support provided.
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Reprint requests: Edwin R. Guzman, MD, Associate Professor of Obstetrics and Gynecology, Director of Antenatal Testing Unit, Saint Peter’s University Hospital, 254 Easton Ave, MOB 4th Floor, New Brunswick, NJ 08903-0591.