Abstract
PurposeTo review our experience with a screening program that included sequential cervical length measurements in our large population of triplet pregnancies.MethodsSeventy-eight triplet pregnancies were retrospectively included. Cervical length measurements were performed by transvaginal ultrasound in 2-week intervals from week 16 + 0 onwards in a tertiary-care center in Vienna. The main outcome measurement was preterm delivery prior to 32 + 0 weeks of gestation. Statistical analyses were performed using paired and unpaired t tests and a stepwise linear regression model.ResultsThere were 26 cases of preterm delivery (33.3%). Women with preterm delivery revealed significant cervical length shortening from week 22 + 0 (median 33 mm, interquartile range, IQR 17–39) to 24 + 0 (median 21 mm, IQR 7–30; p = 0.005). This was not observed in women without preterm delivery. From week 22 + 0 onwards, both groups showed further significant 2-week differences in cervical length (p < 0.05). Univariate analysis of cervical length in weeks 20 + 0, 22 + 0, and 24 + 0 as well as cervical length dynamics from 22 + 0 to 24 + 0 predicted preterm delivery.ConclusionsIn triplet pregnancies, a decrease in cervical length seems physiological from week 22 + 0 onwards. A sharp decrease in cervical length from the 22 + 0 to the 24 + 0 week as well as the smaller cervical length in weeks 20 + 0, 22 + 0, and 24 + 0 increase the risk of preterm delivery.
Highlights
Over the past decades, the incidence of multifetal gestations has increased dramatically which includes triplet pregnancies [1]
Purpose To review our experience with a screening program that included sequential cervical length measurements in our large population of triplet pregnancies
In triplet pregnancies, a decrease in cervical length seems physiological from week 22 ? 0 onwards
Summary
The incidence of multifetal gestations has increased dramatically which includes triplet pregnancies [1]. In these pregnancies, the average pregnancy age at delivery ranges from 31 to 33 completed weeks of gestation, with a majority of triplets being born before the 35th week [2,3,4,5]. One could hypothesize that chorionicity and/or the amount of amniotic fluid might influence cervical length (CL) in triplet pregnancies, probably even without having a major impact on gestational length. The efforts of identifying those women at risk for preterm triplet delivery have
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