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Cervical length at 30–32 weeks and the risk of Cesarean delivery in twin pregnancies
Author(s) -
Fox N. S.,
Rebarber A.,
Roman A. S.,
Klauser C. K.,
Saltzman D. H.
Publication year - 2012
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.10069
Subject(s) - medicine , quartile , obstetrics , vaginal delivery , twin pregnancy , pregnancy , gynecology , cesarean delivery , retrospective cohort study , cohort , gestation , surgery , confidence interval , biology , genetics
Abstract Objectives To estimate the association between the cervical length (CL) measurement at 30–32 weeks and the mode of delivery in twin pregnancies. Methods This was a retrospective study of a cohort, from 2005–2010, of 265 twin pregnancies with a CL measurement at 30–32 weeks. We compared the CL measurement at 30–32 weeks based on mode of delivery. We then analyzed our data across four subgroups, based on the CL measurement quartiles at 30–32 weeks. We performed this analysis in all patients, and also performed a planned subgroup analysis of 130 patients who attempted a vaginal delivery. Results In all patients, including those who attempted a vaginal delivery, the mean CL at 30–32 weeks was significantly shorter in women who delivered vaginally compared with women who had a Cesarean section. The likelihood of Cesarean delivery increased significantly with increasing CL measurement across the groups defined by measurement quartiles. On adjusted analysis controlling for maternal age, race, in‐vitro fertilization, chorionicity, induction of labor and prior vaginal delivery, the CL measurement at 30–32 weeks was independently associated with mode of delivery. Conclusions In twin pregnancies, the CL at 30–32 weeks is significantly associated with the likelihood of Cesarean delivery. A longer CL may represent underdevelopment of the uterus, leading to a higher risk of Cesarean delivery in labor at term. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.