Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

L. Van de Mheen; E. Schuit; S. M. S. Liem; A. C. Lim; D. J. Bekedam; S.M.T.A. Goossens; M. T. M. Franssen; M. M. Porath; M. A. Oudijk; K. W. M. Bloemenkamp; J. J. Duvekot; M. D. Woiski; I. De Graaf; J. M. Sikkema; H. C. J. Scheepers; J. Van Eijk; C. J. M. De Groot; M. G. Van Pampus; B. W. J. Mol

doi:10.1002/uog.14727

Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

L. Van de Mheen^*, E. Schuit, S. M. S. Liem, A. C. Lim, D. J. Bekedam, S.M.T.A. Goossens, M. T. M. Franssen, M. M. Porath, M. A. Oudijk, K. W. M. Bloemenkamp, J. J. Duvekot, M. D. Woiski, I. De Graaf, J. M. Sikkema, H. C. J. Scheepers, J. Van Eijk, C. J. M. De Groot, M. G. Van Pampus, B. W. J. Mol

^*Corresponding author for this work

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Abstract

Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable association between risk indicators, including second-trimester CL in quartiles, and emergency Cesarean delivery using a logistic regression model. For multivariable analysis, we assessed whether adjustment for other risk indicators altered the associations found in univariable (unadjusted) analysis. Separate analyses were performed for suspected fetal distress and failure to progress in labor as indications for Cesarean section. Results In total, 311 women with a twin pregnancy attempted vaginal delivery after 34weeks' gestation. Emergency Cesarean delivery was performed in 111 (36%) women, of which 67 (60%) were performed owing to arrest of labor. There was no relationship between second-trimester CL and Cesarean delivery (adjusted odds ratio (aOR): 0.97 for CL 26th-50th percentiles; 0.71 for CL 51st-75th percentiles; and 0.92 for CL> 75th percentile, using CL 28 kg/m(2)) and induction of labor (aOR, 1.92 (95% CI, 1.05-3.5)). Conclusion In nulliparous women with a twin pregnancy, second-trimester CL is not associated with risk of emergency Cesarean delivery. ISUOG. Published by John Wiley & Sons Ltd.

Original language	English
Pages (from-to)	579-584
Journal	Ultrasound in Obstetrics & Gynecology
Volume	46
Issue number	5
DOIs	https://doi.org/10.1002/uog.14727
Publication status	Published - Nov 2015

Keywords

cervical-length measurement
Cesarean delivery
twin pregnancy

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10.1002/uog.14727

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Van de Mheen, L., Schuit, E., Liem, S. M. S., Lim, A. C., Bekedam, D. J., Goossens, S. M. T. A., Franssen, M. T. M., Porath, M. M., Oudijk, M. A., Bloemenkamp, K. W. M., Duvekot, J. J., Woiski, M. D., De Graaf, I., Sikkema, J. M., Scheepers, H. C. J., Van Eijk, J., De Groot, C. J. M., Van Pampus, M. G., & Mol, B. W. J. (2015). Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy. Ultrasound in Obstetrics & Gynecology, 46(5), 579-584. https://doi.org/10.1002/uog.14727

@article{b3dabf79ff424196b4345348d67e6928,

title = "Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy",

abstract = "Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable association between risk indicators, including second-trimester CL in quartiles, and emergency Cesarean delivery using a logistic regression model. For multivariable analysis, we assessed whether adjustment for other risk indicators altered the associations found in univariable (unadjusted) analysis. Separate analyses were performed for suspected fetal distress and failure to progress in labor as indications for Cesarean section. Results In total, 311 women with a twin pregnancy attempted vaginal delivery after 34weeks' gestation. Emergency Cesarean delivery was performed in 111 (36%) women, of which 67 (60%) were performed owing to arrest of labor. There was no relationship between second-trimester CL and Cesarean delivery (adjusted odds ratio (aOR): 0.97 for CL 26th-50th percentiles; 0.71 for CL 51st-75th percentiles; and 0.92 for CL> 75th percentile, using CL 28 kg/m(2)) and induction of labor (aOR, 1.92 (95% CI, 1.05-3.5)). Conclusion In nulliparous women with a twin pregnancy, second-trimester CL is not associated with risk of emergency Cesarean delivery. ISUOG. Published by John Wiley & Sons Ltd.",

keywords = "cervical-length measurement, Cesarean delivery, twin pregnancy",

author = "{Van de Mheen}, L. and E. Schuit and Liem, {S. M. S.} and Lim, {A. C.} and Bekedam, {D. J.} and S.M.T.A. Goossens and Franssen, {M. T. M.} and Porath, {M. M.} and Oudijk, {M. A.} and Bloemenkamp, {K. W. M.} and Duvekot, {J. J.} and Woiski, {M. D.} and {De Graaf}, I. and Sikkema, {J. M.} and Scheepers, {H. C. J.} and {Van Eijk}, J. and {De Groot}, {C. J. M.} and {Van Pampus}, {M. G.} and Mol, {B. W. J.}",

year = "2015",

month = nov,

doi = "10.1002/uog.14727",

language = "English",

volume = "46",

pages = "579--584",

journal = "Ultrasound in Obstetrics & Gynecology",

issn = "0960-7692",

publisher = "Wiley",

number = "5",

}

Van de Mheen, L, Schuit, E, Liem, SMS, Lim, AC, Bekedam, DJ, Goossens, SMTA, Franssen, MTM, Porath, MM, Oudijk, MA, Bloemenkamp, KWM, Duvekot, JJ, Woiski, MD, De Graaf, I, Sikkema, JM, Scheepers, HCJ, Van Eijk, J, De Groot, CJM, Van Pampus, MG & Mol, BWJ 2015, 'Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy', Ultrasound in Obstetrics & Gynecology, vol. 46, no. 5, pp. 579-584. https://doi.org/10.1002/uog.14727

TY - JOUR

T1 - Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

AU - Van de Mheen, L.

AU - Schuit, E.

AU - Liem, S. M. S.

AU - Lim, A. C.

AU - Bekedam, D. J.

AU - Goossens, S.M.T.A.

AU - Franssen, M. T. M.

AU - Porath, M. M.

AU - Oudijk, M. A.

AU - Bloemenkamp, K. W. M.

AU - Duvekot, J. J.

AU - Woiski, M. D.

AU - De Graaf, I.

AU - Sikkema, J. M.

AU - Scheepers, H. C. J.

AU - Van Eijk, J.

AU - De Groot, C. J. M.

AU - Van Pampus, M. G.

AU - Mol, B. W. J.

PY - 2015/11

Y1 - 2015/11

N2 - Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable association between risk indicators, including second-trimester CL in quartiles, and emergency Cesarean delivery using a logistic regression model. For multivariable analysis, we assessed whether adjustment for other risk indicators altered the associations found in univariable (unadjusted) analysis. Separate analyses were performed for suspected fetal distress and failure to progress in labor as indications for Cesarean section. Results In total, 311 women with a twin pregnancy attempted vaginal delivery after 34weeks' gestation. Emergency Cesarean delivery was performed in 111 (36%) women, of which 67 (60%) were performed owing to arrest of labor. There was no relationship between second-trimester CL and Cesarean delivery (adjusted odds ratio (aOR): 0.97 for CL 26th-50th percentiles; 0.71 for CL 51st-75th percentiles; and 0.92 for CL> 75th percentile, using CL 28 kg/m(2)) and induction of labor (aOR, 1.92 (95% CI, 1.05-3.5)). Conclusion In nulliparous women with a twin pregnancy, second-trimester CL is not associated with risk of emergency Cesarean delivery. ISUOG. Published by John Wiley & Sons Ltd.

AB - Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable association between risk indicators, including second-trimester CL in quartiles, and emergency Cesarean delivery using a logistic regression model. For multivariable analysis, we assessed whether adjustment for other risk indicators altered the associations found in univariable (unadjusted) analysis. Separate analyses were performed for suspected fetal distress and failure to progress in labor as indications for Cesarean section. Results In total, 311 women with a twin pregnancy attempted vaginal delivery after 34weeks' gestation. Emergency Cesarean delivery was performed in 111 (36%) women, of which 67 (60%) were performed owing to arrest of labor. There was no relationship between second-trimester CL and Cesarean delivery (adjusted odds ratio (aOR): 0.97 for CL 26th-50th percentiles; 0.71 for CL 51st-75th percentiles; and 0.92 for CL> 75th percentile, using CL 28 kg/m(2)) and induction of labor (aOR, 1.92 (95% CI, 1.05-3.5)). Conclusion In nulliparous women with a twin pregnancy, second-trimester CL is not associated with risk of emergency Cesarean delivery. ISUOG. Published by John Wiley & Sons Ltd.

KW - cervical-length measurement

KW - Cesarean delivery

KW - twin pregnancy

U2 - 10.1002/uog.14727

DO - 10.1002/uog.14727

M3 - Article

C2 - 25402630

VL - 46

SP - 579

EP - 584

JO - Ultrasound in Obstetrics & Gynecology

JF - Ultrasound in Obstetrics & Gynecology

SN - 0960-7692

IS - 5

ER -