Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies
-
Su Jin Sung
,
Sohee Oh
Abstract
Objective:
It is well known that a short cervix at mid-pregnancy is a risk factor for spontaneous preterm birth in both singleton and twin gestations. Recent evidence also suggests that a long cervix at mid-pregnancy is a predictor of the risk of cesarean section (C/S) in singleton gestation. The purpose of this study was to determine whether a long cervix at mid-pregnancy was associated with an increased risk of C/S in women with twin pregnancies.
Methods:
We enrolled 746 women pregnant with twins whose cervical length was measured by trans-vaginal ultrasonography at a mean of 22 weeks of gestation and who delivered in our institution. Cases with a short cervix [cervical length (CL) <15 mm] were excluded. Cases were divided into four groups according to the quartile of CL.
Results:
The rate of C/S increased according to the quartile of CL (47% in the 1st quartile, 51% in the 2nd quartile, 56% in the 3rd quartile and 62% in the 4th quartile, P<0.005, χ2 for trend). CL was an independent risk factor for C/S even after adjustment for confounding variables. When confining analysis to women who delivered after a trial of labor (n=418), to nulliparous women (n=633) or to those who delivered at late preterm or full term (n=666), the rate of C/S also increased according to the quartile of CL, and the relationship between CL and the risk of C/S remained significant after adjustment in each group.
Conclusion:
In women pregnant with twins, long CL at mid-pregnancy was a risk factor for C/S.
Acknowledgment
This work was supported by a multidisciplinary research grant-in-aid from the Seoul Metropolitan Government Seoul National University (SMG-SNU) Boramae Medical Center (02-2015-4).
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
References
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
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- Editorial
- Antenatal and prepregnancy care – prevention of perinatal morbidity and mortality
- Review article
- Fetal interventional procedures and surgeries: a practical approach
- Opinion paper
- Inverted pyramid of prenatal care – is it enough? Should it be – extended inverted pyramid of prenatal care?
- Research articles
- Expectant management in di-chorionic pregnancies complicated by discordant anomalous twin
- Pregnancy outcomes among patients with recurrent pregnancy loss and uterine anatomic abnormalities
- Early postnatal echocardiographic assessment of pulmonary blood flow in newborns with congenital diaphragmatic hernia
- Sonographic prediction of small and large for gestational age in breech-presenting fetuses
- Comparison of fetal weight distribution improved by paternal height by Spanish standard versus Intergrowth 21st standard
- Can early ultrasonography explain the lower miscarriage rates in twin as compared to singleton pregnancies following assisted reproduction?
- Pregnancy outcomes among patients with recurrent pregnancy loss and chromosomal aberration (CA) without PGD
- Regular research articles
- Induction of labor in twin gestation: can we predict success?
- Low dose aspirin for preventing fetal growth restriction: a randomised trial
- Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies
- Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial
- Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy
- Fetal brain development in diabetic pregnancies and normal controls
- Body composition in preterm infants with intrauterine growth restriction: a cohort study
- Commentary
- Professionally responsible management of gynecologic cancer in pregnancy when clinical resources are unavoidably limited
- Letters to the Editor
- Erroneous conclusion due to mis-calculation of data: reply to Rai SE, Sidhu AK, Krishnan RJ. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis. J Perinat Med 2017
- Reply to: Letter to the Editor by Stritzke A and Shah PS. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis
- Congenital Zika syndrome in non-endemic regions
- Reply to: Congenital Zika syndrome in non-endemic regions: A neuroimaging pattern-based approach
Articles in the same Issue
- Frontmatter
- Editorial
- Antenatal and prepregnancy care – prevention of perinatal morbidity and mortality
- Review article
- Fetal interventional procedures and surgeries: a practical approach
- Opinion paper
- Inverted pyramid of prenatal care – is it enough? Should it be – extended inverted pyramid of prenatal care?
- Research articles
- Expectant management in di-chorionic pregnancies complicated by discordant anomalous twin
- Pregnancy outcomes among patients with recurrent pregnancy loss and uterine anatomic abnormalities
- Early postnatal echocardiographic assessment of pulmonary blood flow in newborns with congenital diaphragmatic hernia
- Sonographic prediction of small and large for gestational age in breech-presenting fetuses
- Comparison of fetal weight distribution improved by paternal height by Spanish standard versus Intergrowth 21st standard
- Can early ultrasonography explain the lower miscarriage rates in twin as compared to singleton pregnancies following assisted reproduction?
- Pregnancy outcomes among patients with recurrent pregnancy loss and chromosomal aberration (CA) without PGD
- Regular research articles
- Induction of labor in twin gestation: can we predict success?
- Low dose aspirin for preventing fetal growth restriction: a randomised trial
- Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies
- Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial
- Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy
- Fetal brain development in diabetic pregnancies and normal controls
- Body composition in preterm infants with intrauterine growth restriction: a cohort study
- Commentary
- Professionally responsible management of gynecologic cancer in pregnancy when clinical resources are unavoidably limited
- Letters to the Editor
- Erroneous conclusion due to mis-calculation of data: reply to Rai SE, Sidhu AK, Krishnan RJ. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis. J Perinat Med 2017
- Reply to: Letter to the Editor by Stritzke A and Shah PS. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis
- Congenital Zika syndrome in non-endemic regions
- Reply to: Congenital Zika syndrome in non-endemic regions: A neuroimaging pattern-based approach
