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Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies.

 Su Jin Sung  ;  Seung Mi Lee  ;  Sohee Oh  ;  Joo Hee Choi  ;  Jee Yoon Park  ;  Byoung Jae Kim  ;  Joon Ho Lee  ;  Chan-Wook Park  ;  Joong Shin Park  ;  Jong Kwan Jun 
 JOURNAL OF PERINATAL MEDICINE, Vol.46(7) : 780-785, 2018 
Journal Title
Issue Date
Cervical length ; cesarean section ; twin
Objective: It is well known that a short cervix at mid-pregnancy is a risk factor for spontaneous preterm birth in both singleton and twin gestations. Recent evidence also suggests that a long cervix at mid-pregnancy is a predictor of the risk of cesarean section (C/S) in singleton gestation. The purpose of this study was to determine whether a long cervix at mid-pregnancy was associated with an increased risk of C/S in women with twin pregnancies. Methods: We enrolled 746 women pregnant with twins whose cervical length was measured by trans-vaginal ultrasonography at a mean of 22 weeks of gestation and who delivered in our institution. Cases with a short cervix [cervical length (CL) <15 mm] were excluded. Cases were divided into four groups according to the quartile of CL. Results: The rate of C/S increased according to the quartile of CL (47% in the 1st quartile, 51% in the 2nd quartile, 56% in the 3rd quartile and 62% in the 4th quartile, P<0.005, χ2 for trend). CL was an independent risk factor for C/S even after adjustment for confounding variables. When confining analysis to women who delivered after a trial of labor (n=418), to nulliparous women (n=633) or to those who delivered at late preterm or full term (n=666), the rate of C/S also increased according to the quartile of CL, and the relationship between CL and the risk of C/S remained significant after adjustment in each group. Conclusion: In women pregnant with twins, long CL at mid-pregnancy was a risk factor for C/S.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Joon Ho(이준호)
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