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Chapter 20 - Prevention of Preterm Birth in Multiple Pregnancies

Published online by Cambridge University Press:  11 October 2022

By
Abdallah Adra
Edited by
Leanne Bricker ,
Julian N. Robinson  and
Baskaran Thilaganathan
Leanne Bricker
Affiliation:
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Affiliation:
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Arguably the most common cause of perinatal mortality and morbidity in multiple gestation is spontaneous preterm labour and delivery. A number of interventions have been evaluated in preventing spontaneous preterm birth in this this context, namely, bed rest (with or without hospitalization), oral tocolytics, home uterine activity monitoring, use of progesterone, cervical cerclage and cervical pessary. Most of the research is in this area relates to twin pregnancy with very little dedicated to triplet and higher order pregnancies. There are conflicting results but in the main, sadly, an effective primary preventative intervention remains elusive. This chapter will summarise what we know about the efficacy of the aforementioned interventions and highlight some specific scenarios where intervention may be beneficial.

Keywords

multiple gestationmultiple pregnancytwin pregnancypreterm birthpreterm preventionpreventative interventions
Type
Chapter
Information
Management of Multiple Pregnancies
A Practical Guide
 , pp. 210 - 220
Publisher: Cambridge University Press
Print publication year: 2022

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References

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