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Risk Assessment and Screening for Preterm Birth in Twin Pregnancy

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Twin and Higher-order Pregnancies

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Abstract

Twins represent 3.2% of all livebirth. However, they account for 20% of all preterm deliveries, with 60% delivering before 37 weeks, and 10.7% before 32 weeks. Twin pregnancies have five times higher risk of early neonatal and infant death related to prematurity. Monochorionic twins have higher incidence of both indicated and spontaneous preterm delivery compared with dichorionic twins. Transvaginal cervical length before 24 weeks is the best tool to predict preterm birth, independent of other risk factors. Among all the evaluated therapies to decrease or prevent preterm birth in twin pregnancies, only vaginal progesterone in women with transvaginal cervical length <25 mm and physical exam indicated cerclage in women with cervical dilation >1 cm have shown a significant decrease in preterm birth and improvement in neonatal outcomes.

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Authors and Affiliations

  1. Maternal Fetal Medicine Division, Obstetrics and Gynecology Department, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

    Amanda Roman, Alexandra Ramirez, Guillermo Gurza & Vincenzo Berghella

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  1. Amanda Roman
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  2. Alexandra Ramirez
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  3. Guillermo Gurza
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  4. Vincenzo Berghella
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Corresponding author

Correspondence to Amanda Roman .

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Editors and Affiliations

  1. Fetal Medicine Unit, St George’s University Hospitals, NHS Foundation Trust, London, UK

    Asma Khalil

  2. Department of Obstetrics & Gynaecology, University Hospitals Leuven, Leuven, Belgium

    Liesbeth Lewi

  3. Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands

    Enrico Lopriore

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Roman, A., Ramirez, A., Gurza, G., Berghella, V. (2021). Risk Assessment and Screening for Preterm Birth in Twin Pregnancy. In: Khalil, A., Lewi, L., Lopriore, E. (eds) Twin and Higher-order Pregnancies. Springer, Cham. https://doi.org/10.1007/978-3-030-47652-6_12

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  • DOI: https://doi.org/10.1007/978-3-030-47652-6_12

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