Zimerman Ariel, Maymon Ron, Viner Yfat, Glick Noa, Herman Arie, Neeman Ortal
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center affiliated with the Tel Aviv University, Sacker Faculty of Medicine, Zerifin, Israel.
Harefuah. 2018 May;157(5):301-304.
Twin pregnancies with short mid-trimester cervical length have a high rate of preterm births.
To compare combined treatment of Arabin cerclage pessary, and intravaginal micronized progesterone to conservative treatment for the prevention of preterm births in twins pregnancies with short cervical length in second trimester of pregnancy.
A retrospective study that compared twin pregnancies with short ≤25mm cervix in second trimester 16-28 gestational weeks treated with combined treatment of Arabin cervical pessary and intravaginal micronized progesterone 200mg TID to a control group with conservative treatment for the prevention of preterm.
The treatment group included 32 patients and the control group 26 patients. Average week at admission was 23 ± 2.2 vs 25 ±3.1 weeks, average cervical length at admission 14.1 ± 2.2 mm vs 13 ±2.1 mm respectively. Average week of delivery 34.4 ±3.9 vs. 33.4 ±4.1, p=0.6 and incidence of delivery ≤28weeks was 9.4% vs. 34% p=0.04.
The treatment group had a lower incidence of preterm birth before 28 weeks. Further prospective studies are needed to assess preterm birth prevention treatments efficacy and the use of Arabin cervical pessary in twins.
孕中期宫颈长度短的双胎妊娠早产率较高。
比较阿拉伯式宫颈托联合阴道内微粒化孕酮与保守治疗对孕中期宫颈长度短的双胎妊娠预防早产的效果。
一项回顾性研究，将孕16 - 28周孕中期宫颈长度≤25mm的双胎妊娠采用阿拉伯式宫颈托联合阴道内微粒化孕酮200mg每日三次治疗的患者与采用保守治疗预防早产的对照组进行比较。
治疗组32例患者，对照组26例患者。入院平均孕周分别为23±2.2周和25±3.1周，入院时平均宫颈长度分别为14.1±2.2mm和13±2.1mm。平均分娩孕周分别为34.4±3.9周和33.4±4.1周，p = 0.6；28周前分娩发生率分别为9.4%和34%，p = 0.04。
治疗组28周前早产发生率较低。需要进一步的前瞻性研究来评估预防早产治疗的疗效以及阿拉伯式宫颈托在双胎妊娠中的应用。
