Twin Pregnancy Preterm Labor | |
Preterm Delivery (before 37 w)
is the most common complication of a twin pregnancy. The average twin pregnancy
delivers at about 35 weeks Women who have
had a previous preterm single baby appear to be at higher risk for preterm
delivery than other women with a twin pregnancy [1,2]. In addition, twin
pregnancies conceived by assisted reproductive technology (in vitro) may also be at
increased risk for preterm delivery compared to women with naturally conceived
twins [3-5]. Lastly women who deliver twins at less than 34 weeks' have an
increased risk of preterm birth in future pregnancies [6].
What Causes Preterm Labor?
Spontaneous (unprovoked) preterm labor may result from several causes including infection, inflammation, vascular
disease (poor blood supply to the uterus and placenta) , an overstretched
uterus, and abnormalities of the cervix . The cause of many preterm
births is never found [18] Prevention of Preterm Labor Bedrest,
intramuscular and long term use of oral medications to stop contractions
(tocolytics) are not recommended for the prevention of preterm labor in multiple
pregnancies because these treatments are either ineffective and/or may cause
harm. Cervical cerclage (stitching the cervix closed) is also not
recommended in multiple pregnancies except in specific circumstances
[7,12] However, vaginal progesterone may
be effective in reducing bad outcomes in women with a twin pregnancy and a
cervical length of 25 mm or less . C If there is enough time the babies can be given a medication
(corticosteroid) to help the lungs mature and reduce other complications of
being born prematurely. A shortened cervix is a strong predictor of
preterm delivery in twin pregnancies . The graph above shows how the risk of preterm
delivery begins to increase rapidly as the cervix shortens to less than 25 mm.
Some health care providers use the cervical
length and the fetal fibronectin test to select twin pregnancies at high risk
for preterm delivery for treatment with corticosteroids before the
mothers have gone into preterm labor. Other REFERENCES: http://www.obfocus.com/high-risk/twins/Complications%20of%20Twin%20Pregnancy%20Preterm%20Delivery.htm Copyright © 2014 by Focus Information Technology. All rights reserved. |