Assessment of cervical length by transvaginal ultrasonography to predict preterm delivery in twin pregnancy.

OBJECTIVE

In singleton pregnancy, short cervix is associated with the risk of spontaneous preterm delivery (SPD). On the other hand, twin pregnancy increases rate of preterm delivery, so this study was designed to evaluate the transvaginal sonographic (TVS) measurement of cervical length (CL) to predict preterm birth in twin pregnancy.

METHODS

This prospective cohort study was performed on 80 twin pregnant women whom the length and funneling of their cervix were evaluated between 22-24 gestational weeks by (TVS). They referred to us at the early signs of labor. Then the gestational age at delivery was recorded. The Fisher exact test and the odds-ratio was used to determine the association between CL and SPD.

RESULTS

Thirty-four (42.5%) women had SPD. Cervical funneling happened in 7.5% of cases and SPD occurred in all women with funneling. There was a significant correlation between CL ≤ 30 mm and SPD (66.7% versus 35.5%, p = 0.029) Also, the risk of SPD was enhanced 3.6 times with CL ≤ 30 mm, CI 95% (1.1-11).

CONCLUSION

We recommend TVS for assessment of CL between 22-24 weeks for prediction of SPD in twin pregnancy.