Spontaneous preterm birth prevention in multiple pregnancy

The Obstetrician & Gynaecologist : the Journal for Continuing Professional Development From the Royal College of Obstetricians & Gynaecologists
Sarah R MurrayJane E Norman

Abstract

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.

References

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Citations

Dec 24, 2018·Acta Obstetricia Et Gynecologica Scandinavica·Anna FicheraEnrico Sartori
Jan 2, 2020·BMC Pregnancy and Childbirth·Annu-Riikka Susanna RissanenMika Erkki Nuutila
May 2, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Hu ShiqiaoJin Lei
Jun 3, 2021·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Chanjuan ZengWeishe Zhang

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