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Best Pract Res Clin Obstet Gynaecol. 2014 Feb;28(2):273-83. doi: 10.1016/j.bpobgyn.2013.11.002. Epub 2013 Dec 4.

Prevention of preterm delivery in twin pregnancy.

Author information

1
Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, 2100 Rigshospitalet, Denmark.
2
Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, 2100 Rigshospitalet, Denmark. Electronic address: ann.tabor@regionh.dk.

Abstract

The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2-3% of all pregnancies but constitute at least 10% of cases of preterm delivery. Complications from preterm birth are not limited to the neonatal period, such as in retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, respiratory disorder and sepsis; they can also constitute sequelae such as abnormal neurophysiological development in early childhood and underachievement in school. Several treatment modalities have been proposed in singleton high-risk pregnancies. The mechanism of initiating labour may, however, be different in singleton and twin gestations. Therefore, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies.

KEYWORDS:

cerclage; cervical length; cervical pessary; prenatal ultrasonography; preterm delivery; progesterone; twin pregnancy

PMID:
24378186
DOI:
10.1016/j.bpobgyn.2013.11.002
[Indexed for MEDLINE]

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