Screening for preterm birth in twin pregnancies

  • Amanda Roman
    Corresponding author: Amanda Roman, MD
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA (Drs Roman and Ramirez)
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  • Alexandra Ramirez
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA (Drs Roman and Ramirez)
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  • Nathan S. Fox
    Maternal Fetal Medicine Associates, PLLC, New York, NY (Dr Fox)

    and Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY (Dr Fox)
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Published:November 19, 2021DOI:


      Twins represent 3.2% of all live births. However, they account for 20% of all preterm deliveries, with 60% delivered before 37 weeks and 10.7% before 32 weeks of gestation. Twin pregnancies have a 5 times higher risk of early neonatal and infant death related to prematurity. Monochorionic twins have a higher incidence of both indicated and spontaneous preterm delivery than dichorionic twins. Additional risk factors include a history of preterm delivery and cervical surgery. The transvaginal cervical length before 24 weeks is the best factor to predict preterm birth, independent of other risk factors.


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