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Correlation of Antepartum Uterine Activity and Cervical Change in Twin Gestation

Published online by Cambridge University Press:  01 August 2014

R. B. Newman ,
J. M. Ellings ,
M. M. O'Reilly ,
B. C. Brost ,
M. C. Miller III  and
D. Gates Jr
R. B. Newman*
Affiliation:
Department of Obstetrics and Gynecology; Biostatistics, Epidemiology and Statistical Sciences, Medical University of South Carolina, Charleston, South Carolina
J. M. Ellings
Affiliation:
Department of Obstetrics and Gynecology; Biostatistics, Epidemiology and Statistical Sciences, Medical University of South Carolina, Charleston, South Carolina
M. M. O'Reilly
Affiliation:
Department of Obstetrics and Gynecology; Biostatistics, Epidemiology and Statistical Sciences, Medical University of South Carolina, Charleston, South Carolina
B. C. Brost
Affiliation:
Department of Obstetrics and Gynecology; Biostatistics, Epidemiology and Statistical Sciences, Medical University of South Carolina, Charleston, South Carolina
M. C. Miller III
Affiliation:
Department of Obstetrics and Gynecology; Biostatistics, Epidemiology and Statistical Sciences, Medical University of South Carolina, Charleston, South Carolina
D. Gates Jr
Affiliation:
Department of Obstetrics and Gynecology; Biostatistics, Epidemiology and Statistical Sciences, Medical University of South Carolina, Charleston, South Carolina
*
Department of Obstetrics and Gynecology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29425-2233, USA

Abstract

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Objective. To determine the correlation between quantitative measurements of antepartum uterine activity and cervical change twin gestations.

Methods. Forty women from our Twin Clinic constituted the study group. Participants had a cervical examination each week between 20 and 37 weeks gestation and a cervical score (CS) was calculated as follows: CS = cervical length (cms)-cervical dilation (cms) at the internal os. The women also performed blinded home uterine activity monitoring (HUAM) for a mean of 7.0+3.0 hrs/wk (+SD). Uterine activity was expressed as mean number of contractions/hour/week gestation based on the average of three independent reviewers. CS was determined by a single clinician unaware of the HUAM recordings. A significant change in the CS was defined as a reduction of at least 0.5 from the preceding week. Correlation coefficients were used to determine the association between uterine activity and change in the cervical score.

Results. Twin pregnancy was characterized by a rise from 0.2 + .03 contractions/hr at 20 weeks to 3.2 + 2.4 contractions/hr at 37 weeks gestation. CS fell from a mean of 2.6 + 0.2 at 20 weeks to −2.1 + 0.9 at 37 weeks gestation. There was a significant negative correlation (−0.317, p<.0001) between increasing uterine activity and decreasing CS. There were significantly more (p <.002) contractions during the 7 days preceding a significant reduction in CS (3.3 + 3.5 contractions/hr) than when the CS was unchanged (1.6±1.5 contractions/hr).

Conclusions. In twin gestations, an increasing frequency of uterine contractions is strongly correlated with quantifiable cervical change between 20-37 weeks gestation. Persistent daytime contraction frequencies of >3/hr represent a risk factor for cervical dilation and/or effacement.

Keywords

Uterine contractionsCervical scoreCervical changeTwin gestationsUterine activity monitoringPreterm labor
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 46 , Issue 1 , January 1997 , pp. 1 - 7
Copyright
Copyright © The International Society for Twin Studies 1997

References

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