Twins represent 3.2% of all live births; however, they account for 20.0% of all preterm
deliveries, with 60.0% and 10.7% of twins delivered before 37 and 32 weeks’ gestation,
respectively. Twin pregnancies have 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. Transvaginal ultrasound
of the cervical length before 24 weeks’ gestation is the best tool to predict preterm
birth, independent of other risk factors. Among all evaluated therapies to decrease
or prevent preterm birth in twin pregnancies, the use of vaginal progesterone in women
with a transvaginal cervical length of <25 mm decreased neonatal morbidity, and physical
examination-indicated cerclage in women with a cervical dilation of >1 cm showed a
significant decrease in preterm birth at different gestational ages and perinatal
mortality.
Keywords
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Article info
Publication history
Published online: December 08, 2021
Accepted:
December 3,
2021
Received in revised form:
November 1,
2021
Received:
June 21,
2021
Footnotes
This study received no external financial support.
The authors report no conflict of interest.
Identification
Copyright
© 2021 Published by Elsevier Inc.
