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Q&A

Obstetric Quality and Safety

Poster Session 4

(1061) Short cervical length in asymptomatic twin pregnancies and optimal timing of antenatal corticosteroid therapy

Wednesday, February 14, 2024

1:00 PM – 2:30 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Anne Leostic, MD, MSc

Intercommunal Hospital of Poissy Saint Germain-en-Laye, Paris Saclay University Hospital
Poissy, Ile-de-France, France

Coauthor(s)

AR

Anne Rousseau, PhD

Intercommunal Hospital of Poissy Saint Germain-en-Laye, Paris Saclay University Hospital
Poissy, Ile-de-France, France
AB

Alexandra Benachi, MD, PhD

Obstetrics and Gynecology Departement
Antoine Béclère Hospital, Paris Saclay University Hospital
Clamart, Ile-de-France, France
pr

patrick rozenberg, MD, PhD

American Hospital of Paris, France
Neuilly-sur-Seine, Ile-de-France, France
AV

Alexandre Vivanti, MD, PhD

Antoine Béclère Hospital, Paris Saclay University Hospital
Clamart, Ile-de-France, France
Paul Berveiller, MD, PhD (he/him/his)

Head of Obstetrics
Centre Hospitalier Intercommunal de Poissy Saint Germain
Poissy, France

Objective: Identification of an ultrasonographic short cervical length (CL) is useful to predict a spontaneous preterm delivery in asymptomatic twin pregnancies, but data are sparce regarding relation between short CL and risk of PB in the forthcoming 7 days. Therefore, there is no evidence that a diagnosis of short CL in asymptomatic twin pregnancy may justify the administration of antenatal corticosteroid (ACS) therapy. We aimed to assess whether a short CL in asymptomatic twin pregnancies was associated with a significant risk of delivery within 7 days following CL measurement.

Study Design: We performed a retrospective cohort study of twin pregnancies followed and delivered in a referral university hospital from January 1, 2007, to December 31, 2017. Asymptomatic twin pregnancies had sequential ultrasound measurements of the CL every four weeks from 21 to 34 weeks of gestation. The primary outcome was the delivery in the forthcoming 7 days after first CL measurement < 25 mm. Secondary outcomes included interval between first CL measurement < 25 mm and delivery, and preterm delivery rate before 34 and 37 weeks of gestation. In addition to the 25 mm CL threshold, we evaluated theses outcomes according to the thresholds of 20, 15 and 10 mm.

Results: Of 1,285 asymptomatic twin pregnancies, a short CL of < 25 mm was observed in 28.1 % (n = 361) women at mean gestational age of 29.0 +/- 3.4 weeks, and was not associated with a significant rate of delivery in the forthcoming 7 days after first CL measurement < 25 mm (2.8 %). The mean interval between first CL measurement < 25 mm and delivery was 47 days (+/- 24). No difference was observed in theses outcomes for any of the thresholds. Moreover, 77.6 % of women followed for a CL of < 25 mm finally delivered after 34 weeks.

Conclusion: In this retrospective cohort study of asymptomatic twin pregnancies, CL measurement of < 25 mm by routine transvaginal ultrasound was not associated with a significant risk of delivery in the forthcoming 7 days (only 2.8 %). Therefore, we cannot recommend its use in routine follow-up in order to indicate properly ACS therapy.