Murray Sarah R, Stock Sarah J, Cowan Shona, Cooper Elizabeth Sarah, Norman Jane E
MRC Centre for Reproductive Health Queen's Medical Research Institute University of Edinburgh Edinburgh EH16 4TJ UK.
Royal Infirmary Edinburgh Edinburgh EH16 4SA UK.
Obstet Gynaecol. 2018 Jan;20(1):57-63. doi: 10.1111/tog.12460. Epub 2018 Jan 28.
Twin pregnancies are associated with a three-fold greater perinatal mortality than singleton pregnancies. Prematurity is a main contributor, with 50% of twin pregnancies delivering before 37 weeks and 10% delivering before 32 weeks of gestation.The aetiology of preterm delivery in twin pregnancies is likely multifactorial and different from that of singletons.Cervical cerclage reduces preterm birth rates in singletons but has mixed results in twins with some studies showing harm.The use of progesterone to prevent preterm birth in singletons has conflicting results and has not been proven to prevent preterm birth in twins. Studies continue to determine whether the cervical pessary is effective in preventing preterm birth in multiple pregnancies.There is a paucity of data available on the prevention of preterm birth in triplets/higher order multiples but similar principles to twin pregnancy apply.
To review the burden of preterm birth in multiple pregnancy.To understand the methods available for preventing preterm birth in multiple pregnancies and the evidence surrounding the use of each one.To be aware of the use of the Arabin pessary.
双胎妊娠的围产期死亡率比单胎妊娠高三倍。早产是主要原因，50%的双胎妊娠在妊娠37周前分娩，10%在妊娠32周前分娩。双胎妊娠早产的病因可能是多因素的，且与单胎妊娠不同。宫颈环扎术可降低单胎妊娠的早产率，但在双胎妊娠中结果不一，一些研究显示有不良影响。使用孕激素预防单胎妊娠早产的结果相互矛盾，且尚未被证明可预防双胎妊娠早产。研究仍在确定宫颈托是否能有效预防多胎妊娠早产。关于三胎及以上多胎妊娠预防早产的数据很少，但与双胎妊娠适用类似原则。
回顾多胎妊娠早产的负担。了解预防多胎妊娠早产的可用方法以及每种方法使用的相关证据。了解阿拉伯式宫颈托的使用。
