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Titel
Cervical length dynamics in triplet pregnancies : a retrospective cohort study
Verfasser / VerfasserinOtt, Johannes ; Pils, Sophie ; Springer, Stephanie ; Wehrmann, Verena ; Chalubinski, Kinga
Erschienen in
Archives of Gynecology and Obstetrics, 2017, Jg. 296, H. 2, S. 191-198
ErschienenSpringer, 2017
SpracheEnglisch
DokumenttypAufsatz in einer Zeitschrift
Schlagwörter (EN)Cervical insufficiency / Cervical length / Preterm delivery / Multiple pregnancy / Triplet pregnancy
URNurn:nbn:at:at-ubmuw:3-3591 Persistent Identifier (URN)
DOI10.1007/s00404-017-4402-0 
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Cervical length dynamics in triplet pregnancies [0.83 mb]
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Zusammenfassung (Englisch)

Purpose

To review our experience with a screening program that included sequential cervical length measurements in our large population of triplet pregnancies.

Methods

Seventy-eight triplet pregnancies were retrospectively included. Cervical length measurements were performed by transvaginal ultrasound in 2-week intervals from week 16 + 0 onwards in a tertiary-care center in Vienna. The main outcome measurement was preterm delivery prior to 32 + 0 weeks of gestation. Statistical analyses were performed using paired and unpaired t tests and a stepwise linear regression model.

Results

There were 26 cases of preterm delivery (33.3%). Women with preterm delivery revealed significant cervical length shortening from week 22 + 0 (median 33 mm, interquartile range, IQR 1739) to 24 + 0 (median 21 mm, IQR 730; p = 0.005). This was not observed in women without preterm delivery. From week 22 + 0 onwards, both groups showed further significant 2-week differences in cervical length (p < 0.05). Univariate analysis of cervical length in weeks 20 + 0, 22 + 0, and 24 + 0 as well as cervical length dynamics from 22 + 0 to 24 + 0 predicted preterm delivery.

Conclusions

In triplet pregnancies, a decrease in cervical length seems physiological from week 22 + 0 onwards. A sharp decrease in cervical length from the 22 + 0 to the 24 + 0 week as well as the smaller cervical length in weeks 20 + 0, 22 + 0, and 24 + 0 increase the risk of preterm delivery.

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CC-BY-Lizenz (4.0)Creative Commons Namensnennung 4.0 International Lizenz