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Chapter 19 - Risk Assessment and Screening for Preterm Birth in Multiple Pregnancy

Published online by Cambridge University Press:  11 October 2022

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

Twins represent 3% of all live birth. However, they account for 20% of all preterm deliveries, with 60% delivering before 37 weeks, and 10.7% before 32 weeks. Twin pregnancies have five times higher risk of early neonatal and infant death related to prematurity. Monochorionic twins have higher incidence of both indicated and spontaneous preterm delivery compared with dichorionic twins. Transvaginal cervical length before 24 weeks is the best tool to predict preterm birth, independent of other risk factors.

Type
Chapter
Information
Management of Multiple Pregnancies
A Practical Guide
, pp. 201 - 209
Publisher: Cambridge University Press
Print publication year: 2022

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References

Blencowe, H, Cousens, S, Oestergaard, MZ et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012 Jun 9;379(9832):2162–72. PubMed PMID: 22682464.CrossRefGoogle ScholarPubMed
Nour, NM. Premature delivery and the millennium development goal. Rev Obstet and Gynecol 2012;5(2):100–5. PubMed PMID: 22866189. Pubmed Central PMCID: 3410509.Google ScholarPubMed
Liu, L, Oza, S, Hogan, D et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 2016 Dec 17;388(10063):3027–35. PubMed PMID: 27839855. Pubmed Central PMCID: 5161777.Google Scholar
Martin, JA, Hamilton, BE, Osterman, MJK. Births in the United States, 2018. NCHS data brief. 2019 Jul(346):18. PubMed PMID: 31442195.Google Scholar
Busnelli, A, Dallagiovanna, C, Reschini, M, Paffoni, A, Fedele, L, Somigliana, E. Risk factors for monozygotic twinning after in vitro fertilization: a systematic review and meta-analysis. Fertil Steril 2019 Feb;111(2):302–17. PubMed PMID: 30691632.CrossRefGoogle ScholarPubMed
Anthoulakis, C, Dagklis, T, Mamopoulos, A, Athanasiadis, A. Risks of miscarriage or preterm delivery in trichorionic and dichorionic triplet pregnancies with embryo reduction versus expectant management: a systematic review and meta-analysis. Hum Repr. 2017 Jun 1;32(6):1351–9. PubMed PMID: 28444191.Google ScholarPubMed
Roman, A, Saccone, G, Dude, CM et al. Midtrimester transvaginal ultrasound cervical length screening for spontaneous preterm birth in diamniotic twin pregnancies according to chorionicity. Eur J Obstet Gynecol Reprod Biol 2018 Oct;229:5763. PubMed PMID: 30107361.CrossRefGoogle ScholarPubMed
D’Antonio, F, Benlioglu, C, Sileo, FG et al. Perinatal outcomes of twin pregnancies affected by early twin–twin transfusion syndrome: A systematic review and meta-analysis. Acta obstetricia et gynecologica Scandinavica 2020 Mar 11. PubMed PMID: 32162305.CrossRefGoogle Scholar
Gratacos, E, Lewi, L, Munoz, B et al. A classification system for selective intrauterine growth restriction in monochorionic pregnancies according to umbilical artery Doppler flow in the smaller twin. Ultrasound Obstet Gynecol 2007 Jul;30(1):2834. PubMed PMID: 17542039.CrossRefGoogle ScholarPubMed
D’Antonio, F, Thilaganathan, B, Dias, T, Khalil, A, Southwest Thames Obstetric Research Center. Influence of chorionicity and gestational age at single fetal loss on risk of preterm birth in twin pregnancy: analysis of STORK multiple pregnancy cohort. Ultrasound Obstet Gynecol 2017 Dec;50(6):723–7. PubMed PMID: 28150444.Google Scholar
Tarter, JG, Khoury, A, Barton, JR, Jacques, DL, Sibai, BM. Demographic and obstetric factors influencing pregnancy outcome in twin gestations. Am J Obstet Gynecol 2002 May;186(5):910–12. PubMed PMID: 12015510.CrossRefGoogle ScholarPubMed
Wisborg, K, Henriksen, TB, Secher, NJ. Maternal smoking and gestational age in twin pregnancies. Acta obstetricia et gynecologica Scandinavica 2001 Oct;80(10):926–30. PubMed PMID: 11580737.CrossRefGoogle ScholarPubMed
Henry, DE, McElrath, TF, Smith, NA. Preterm severe preeclampsia in singleton and twin pregnancies. J Perinatol 2013 Feb;33(2):94–7. PubMed PMID: 22678139.CrossRefGoogle ScholarPubMed
Moini, A, Shiva, M, Arabipoor, A, Hosseini, R, Chehrazi, M, Sadeghi, M. Obstetric and neonatal outcomes of twin pregnancies conceived by assisted reproductive technology compared with twin pregnancies conceived spontaneously: a prospective follow-up study. Eur J Obstet Gynecol Reprod Biol 2012 Nov;165(1):2932. PubMed PMID: 22884795.Google Scholar
Goldenberg, RL, Iams, JD, Miodovnik, M et al. The preterm prediction study: risk factors in twin gestations. National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network.Am J Obstet Gynecol 1996 Oct;175 (4 Pt 1):1047–53. PubMed PMID: 8885774.CrossRefGoogle ScholarPubMed
Kindinger, LM, Poon, LC, Cacciatore, S et al. The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta-analysis. BJOG 2016 May;123(6):877–84. PubMed PMID: 26333191.CrossRefGoogle ScholarPubMed
Spiegelman, J, Booker, W, Gupta, S et al. The independent association of a short cervix, positive fetal fibronectin, amniotic fluid sludge, and cervical funneling with spontaneous preterm birth in twin pregnancies. Am J Perinatol 2016 Oct;33(12):1159–64. PubMed PMID: 27434692.Google Scholar
Bivins, HA Jr, Newman, RB, Ellings, JM, Hulsey, TC, Keenan, A. Risks of antepartum cervical examination in multifetal gestations. Am J Obstet Gynecol 1993 Jul;169(1):22–5. PubMed PMID: 8333461.Google Scholar
Colton, T, Kayne, HL, Zhang, Y, Heeren, T. A metaanalysis of home uterine activity monitoring. Am J Obstet Gynecol 1995 Nov;173(5):14991505. PubMed PMID: 7503191.CrossRefGoogle ScholarPubMed
Marleen, S, Dias, C, MacGregor, R et al. Biochemical predictors of preterm birth in twin pregnancies: a systematic review involving 6077 twin pregnancies. Eur J Obstet Gynecol Reprod Biol 2020 May 5;250:130–42. PubMed PMID: 32446146.Google Scholar

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