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Outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency compared to singleton pregnancies

Authors
  • Park, Jee Yoon
  • Cho, Soo-hyun
  • Jeon, Se Jeong
  • Kook, Song Yi
  • Park, Hyunsoo
  • Oh, Kyung Joon
  • Hong, Joon-Seok
Type
Published Article
Journal
Journal of Perinatal Medicine
Publisher
Walter de Gruyter GmbH
Publication Date
Nov 08, 2017
Volume
46
Issue
8
Pages
845–852
Identifiers
DOI: 10.1515/jpm-2017-0218
Source
De Gruyter
Keywords
License
Yellow

Abstract

Objectives To compare pregnancy outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency with that of singletons. Methods This retrospective cohort study included 88 consecutive women (17 twins and 71 singletons) who had undergone physical examination-indicated cerclage because of acute cervical insufficiency (defined as painless cervical dilation with (1) prolapsed and/or visible membranes at the external cervical os on speculum examination and (2) a functional cervical length of zero on transvaginal ultrasound) between 160/7 and 236/7 weeks. The primary outcome measure was preterm delivery <34 weeks. Results (1) The frequency of preterm delivery <34 weeks was not significantly different between the two groups [twins, 56% (9/16) vs. singleton, 53% (37/70), P>0.999]. (2) The perinatal mortality was 21% (7/34) in twins and 32% (23/71) in singletons. (3) The median gestational age at delivery for twin pregnancies was 31.0 weeks (IQR, 22.6–36.5 weeks), which was similar to that of singleton pregnancies (median 32.4 weeks; IQR 22.3–38.3 weeks). (4) There were no significant differences in preterm delivery before 28 and 32 weeks, interval from cerclage to delivery within 1, 2, 4 and 8 weeks and neonatal morbidities between the two groups. Conclusion The obstetric and neonatal outcomes of physical examination-indicated cerclage in twin pregnancies were comparable to those in singleton pregnancies.

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