Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids
-
Louis Marcellin
,
Marie Victoire Senat
Abstract
Objective:
To evaluate whether routine measurement of cervical length (CL) by transvaginal ultrasound (TVU) in twin pregnancies can enable identification of women who will give birth before 34 weeks and require antenatal corticosteroids (ACSs), and whether it can limit their administration to women who will give birth later.
Study design:
Retrospective comparative study in two tertiary referral centers in France. Women with twin gestations followed in two tertiary university hospital maternity units and who delivered from January 1, 2007 to December 31, 2009 were included. In one center, TVU was targeted to women with cases of suspected preterm labor, while the other center used it monthly for all twin pregnancies. The main outcome measure was the administration of a full course of ACS to twins delivered before 34 weeks.
Results:
Two hundred and seventy women were eligible in the “targeted use” group, and 296 women in the “routine use” group. The rate of administration of at least one full course of ACS for twins born before 34 weeks did not differ between the two groups (85.0% in the targeted use group and 90.0% in the routine use group, P=0.40), but the rate of such administration for those born after 34 weeks was lower in the targeted use group (25.7% vs. 81.2%, P<0.01). On adjusting for confounders using logistic regression modeling, no significant difference in ACS administration before 34 weeks was found between the two groups [adjusted odds ratio (aOR), 0.71, 95% confidence interval (CI), 0.39–1.30].
Conclusion:
Routine monitoring performed every month of CL with TVU does not affect the rate of administration of ACS to twins born before 34 weeks, but is associated with a higher rate of such administration for those born later in the specific center of the study.
Acknowledgments
We are indebted to Marie-Sophie Civadier, Anne Gaelle Cordier, Florent Fuchs, Julie Tort, Michelle Breuiller-Fouché and Céline Méhats for their contribution to this work, and Emma Walton and Jo Ann Cahn for editing the article.
Contribution to authorship: LM designed the study and wrote the article with MVS and FG. LM and SR gathered the data from medical files and wrote the preliminary report. AB and DC provided significant help by reviewing the article. MVS and FG supervised the entire process. All authors were involved in the critical refinement of the article. All authors approved the final version.
Details of ethics approval: The study was approved by the Institutional Review Board and complied with the legal requirements of the Commission Nationale de l’Informatique et des Libertés (CNIL declaration n 1755849v0, April 10, 2014).
Funding: None.
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2017 Walter de Gruyter GmbH, Berlin/Boston
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- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Editorial
- Antepartum care
- Academy’s Paper
- Late pregnancy – a clue to prolonging life?
- Highlight articles
- The effect of cigarette smoking on fetal heart rate tracing during pregnancy
- Correlation between markers of DNA and lipid oxidative damage in maternal and fetoplacental compartment in the mid-trimester of pregnancy
- Hyperemesis gravidarum is associated with increased maternal serum ischemia-modified albumin
- Can prepartum thromboelastometry-derived parameters and fibrinogen levels really predict postpartum hemorrhage?
- Effect of DHA supplements during pregnancy on the concentration of PUFA in breast milk of Chinese lactating mothers
- Ferric carboxymaltose vs. oral iron in the treatment of pregnant women with iron deficiency anemia: an international, open-label, randomized controlled trial (FER-ASAP)
- Maternal and perinatal outcomes in pregnancies with multiple sclerosis: a case-control study
- The role of vitamin B1-B2 and plasma lipid profile in intrahepatic cholestasis of pregnancy
- Hyponatremia associated with preeclampsia
- Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids
- Does an ideal prototype of a twin mother exist?
- Differential immunophenotype of macrophages in acute and chronic chorioamnionitis
- Longitudinal changes of cardiotocographic parameters throughout pregnancy: a prospective cohort study comparing small-for-gestational-age and normal fetuses from 24 to 40 weeks
- Congress Calendar
- Congress Calendar
