Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA (Drs Roman and 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).
Am J Obstet Gynecol MFM. 2022 Mar;4(2S):100551. doi: 10.1016/j.ajogmf.2021.100551. Epub 2021 Dec 8.
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.
双胞胎占所有活产儿的 3.2%；然而，它们占所有早产的 20.0%，分别有 60.0%和 10.7%的双胞胎在 37 周和 32 周之前分娩。双胞胎妊娠的早期新生儿和婴儿因早产相关的死亡风险高 5 倍。单绒毛膜双胞胎的有指征和自发性早产的发生率均高于双绒毛膜双胞胎。在 24 周妊娠前经阴道超声测量宫颈长度是预测早产的最佳工具，独立于其他危险因素。在所有评估的减少或预防双胞胎妊娠早产的治疗方法中，经阴道使用孕酮可降低新生儿发病率，而对于宫颈扩张>1cm 的患者，体检指征的宫颈环扎术可显著降低不同胎龄和围生期死亡率的早产率。
