Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies

Author:

Sung Su Jin1,Lee Seung Mi1,Oh Sohee2,Choi Joo Hee1,Park Jee Yoon1,Kim Byoung Jae13,Lee Joon Ho1,Park Chan-Wook1,Park Joong Shin1,Jun Jong Kwan1

Affiliation:

1. Department of Obstetrics and Gynecology , Seoul National University College of Medicine , Seoul , Korea

2. Department of Biostatistics , Seoul Metropolitan Government Seoul National University Boramae Medical Center , Seoul , Korea

3. Department of Obstetrics and Gynecology , Seoul Metropolitan Government Seoul National University Boramae Medical Center , Seoul , Korea

Abstract

Abstract Objective: It is well known that a short cervix at mid-pregnancy is a risk factor for spontaneous preterm birth in both singleton and twin gestations. Recent evidence also suggests that a long cervix at mid-pregnancy is a predictor of the risk of cesarean section (C/S) in singleton gestation. The purpose of this study was to determine whether a long cervix at mid-pregnancy was associated with an increased risk of C/S in women with twin pregnancies. Methods: We enrolled 746 women pregnant with twins whose cervical length was measured by trans-vaginal ultrasonography at a mean of 22 weeks of gestation and who delivered in our institution. Cases with a short cervix [cervical length (CL) <15 mm] were excluded. Cases were divided into four groups according to the quartile of CL. Results: The rate of C/S increased according to the quartile of CL (47% in the 1st quartile, 51% in the 2nd quartile, 56% in the 3rd quartile and 62% in the 4th quartile, P<0.005, χ2 for trend). CL was an independent risk factor for C/S even after adjustment for confounding variables. When confining analysis to women who delivered after a trial of labor (n=418), to nulliparous women (n=633) or to those who delivered at late preterm or full term (n=666), the rate of C/S also increased according to the quartile of CL, and the relationship between CL and the risk of C/S remained significant after adjustment in each group. Conclusion: In women pregnant with twins, long CL at mid-pregnancy was a risk factor for C/S.

Publisher

Walter de Gruyter GmbH

Subject

Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health

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