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

Abstract

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.

• Funneling of cervix
• short cervix
• spontaneous preterm delivery
• transvaginal ultrasonography

Acknowledgements

We thank the staffs of Yahyanejad Hospital, Fatemezahra Infertility and Reproductive Health Research Center, and Dr Evangeline Foronda for proofreading the manuscript and the rest of those who collaborated in this study.