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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


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1619-3997
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Volume 43, Issue 4

Issues

Advanced cervical dilatation and spontaneous preterm labor: a comparison between twin and singleton gestations

Michal Dviri
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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/ Michal J. Simchen
  • Corresponding author
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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/ Anat Kalter
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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/ Shali Mazaki Tovi
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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/ Orit Moran
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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/ Eyal Schiff
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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/ Eyal Sivan
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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/ Israel Hendler
  • Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Published Online: 2014-02-19 | DOI: https://doi.org/10.1515/jpm-2013-0316

Abstract

Objective: To determine the admission to delivery interval and the rate of immediate delivery in twin versus singleton gestation complicated by spontaneous preterm labor (SPTL).

Methods: A retrospective cohort study of pregnant women presenting with advanced cervical dilatation of 3–5 cm and frequent uterine contractions at 24–34 weeks of gestation was performed. The rate of progression to delivery within 12 h and 24 h, as well as rates of prolonged latency, were compared between twins and singletons gestations.

Results: Sixty-nine women were included, of which 25 carried twins and 44 singletons. The overall rate of spontaneous delivery within 12 h and 24 h was 47.8% and 59.4%, respectively, and similar between twins and singletons. Nevertheless, prolonged latency of 10 days or more after presentation was more frequent among twins compared with singletons [10/25 (40%) vs. 7/44 (15.9%), respectively; P=0.026]. Moreover, women carrying twins presenting with advanced cervical dilatation had a better chance of completing a full 2-dose antenatal betamethasone course compared with singletons [19/25 (76%) of twins compared with 21/44 (47.7%) of singletons, odds ratio 3.5, 95% confidence interval 1.16–10.34; P=0.022].

Conclusion: Up to 60% of women presenting with advanced cervical dilatation prior to 34 weeks’ gestation give birth within 24 h. Nevertheless, women carrying twins have a better chance of completing a betamethasone course and having prolonged latency compared with singletons.

Keywords: Advanced cervical dilatation; imminent labor; labor progression; multifetal pregnancy; preterm labor; twin pregnancy

References

  • [1]

    Bastek JA, Sammel MD, Srinivas SK, McShea MA, Foreman MN, Elovitz MA, et al. Clinical prediction rules for preterm birth in patients presenting with preterm labor. Obstet Gynecol. 2012;119:1119–28.Google Scholar

  • [2]

    Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88:31–8.Google Scholar

  • [3]

    Chauhan SP, Scardo JA, Hayes E, Abuhamad AZ, Berghella V. Twin: prevalence, problems, and preterm births. Am J Obstet Gynecol. 2010;203:305–15.Google Scholar

  • [4]

    Copper RL, Goldenberg RL, Dubard MB, Hauth JC, Cutter GR. Cervical examination and tocodynamometry at 28 weeks’ gestation: prediction of spontaneous preterm birth. Am J Obstet Gynecol. 1995;172:666–71.Web of ScienceGoogle Scholar

  • [5]

    Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Preterm birth. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY, editors. Williams Obsteterics. New York: McGraw-Hill; 2010. p. 804–31.Google Scholar

  • [6]

    Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consensus Statement. 1994;12:1–24.PubMedGoogle Scholar

  • [7]

    Fuchs IB, Henrich W, Osthues K, Dudenhausen JW. Sonographic cervical length in singleton pregnancies with intact membranes presenting with threatened preterm labor. Ultrasound Obstet Gynecol. 2004;24:554–7.CrossrefPubMedGoogle Scholar

  • [8]

    How HY, Khoury JC, Sibai BM. Cervical dilatation on presentation for preterm labor and subsequent preterm birth. Am J Perinatol. 2009;26:1–6.Web of SciencePubMedCrossrefGoogle Scholar

  • [9]

    Iams JD, Romero R. Preterm birth. In: Gabbe SG, Niebyl JR, Simpson JL, editors. Obstetrics: normal and problem pregnancies. Maryland Heights: Churchill Livingstone; 2007. p. 669–76.Google Scholar

  • [10]

    Jain S, Earhart A, Ruddock N, Wen T, Hankins GD, Saade GR. The validity of cervical dilation as an indication of true labor between 32 and 36 weeks 6 days of gestation. Am J Obstet Gynecol. 2007;197:431.e1–3.Web of ScienceGoogle Scholar

  • [11]

    Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Osterman MJ. Births: final data for 2008. Natl Vital Stat Rep. 2010;59:3–71.Google Scholar

  • [12]

    Pereira L, Cotter A, Gómez R, Berghella V, Prasertcharoensuk W, Rasanen J, et al. Expectant management compared with physical examination-indicated cerclage (EM-PEC) in selected women with a dilated cervix at 14(0/7)-25(6/7) weeks: results from the EM-PEC international cohort study. Am J Obstet Gynecol. 2007;197:483.e1–8.Google Scholar

  • [13]

    Psomiadis N, Goldkrand J. Efficacy of aggressive tocolysis for preterm labor with advanced cervical dilatation. J Matern Fetal Neonatal Med. 2005;18:47–52.Google Scholar

  • [14]

    Simchen MJ, Dulitzky M, Mashiach S, Schiff E. Does preterm cervical dilatation imply imminent labor in twin pregnancies? Eur J Obstet Gynecol Reprod Biol. 2002;103:119–21.Google Scholar

  • [15]

    Tsoi E, Akmal S, Geerts L, Jeffery B, Nicolaides KH. Sonographic measurement of cervical length and fetal fibronectin testing in threatened preterm labor. Ultrasound Obstet Gynecol. 2006;27:368–72.PubMedCrossrefGoogle Scholar

  • [16]

    Vis JY, Wilms FF, Kuin RA, Reuvers JM, Stam MC, Pattinaja DA, et al. Time to delivery after the first course of antenatal corticosteroids: a cohort study. Am J Perinatol. 2011;28:683–8.PubMedCrossrefGoogle Scholar

  • [17]

    Wapner RJ, Sorokin Y, Thom EA, Johnson F, Dudley DJ, Spong CY, et al. Single versus weekly courses of antenatal corticosteroids: evaluation of safety and efficacy. Am J Obstet Gynecol. 2006;195:633–42.Google Scholar

  • [18]

    Wilms FF, Vis JY, Pattinaja DA, Kuin RA, Stam MC, Reuvers JM, et al. Relationship between the time interval from antenatal corticosteroid administration until preterm birth and the occurrence of respiratory morbidity. Am J Obstet Gynecol. 2011;205:49.e1–7.Web of ScienceGoogle Scholar

About the article

Corresponding author: Michal J. Simchen, MD, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Ramat Gan, 52621, Israel, Tel.: +972-3-5302169, Fax: 972-3-5303944, E-mail: ;


Received: 2013-11-20

Accepted: 2014-01-17

Published Online: 2014-02-19

Published in Print: 2015-07-01


Citation Information: Journal of Perinatal Medicine, Volume 43, Issue 4, Pages 391–394, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2013-0316.

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