ArticleAmerican journal of obstetrics and gynecology2016
Serial cervical length determination in twin pregnancies reveals 4 distinct patterns with prognostic significance for preterm birth.
Article in American journal of obstetrics and gynecology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Prior Spontaneous or Induced Abortion Is a Risk Factor for Cervical Dysfunction in Pregnant Women: a Systematic Review and Meta-analysis.Reproductive sciences (Thousand Oaks, Calif.) · 2023Pooled it
- Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis.American journal of obstetrics and gynecology · 2018Pooled it
- Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data.American journal of obstetrics and gynecology · 2018Pooled it
- Vaginal progesterone decreases preterm birth and neonatal morbidity and mortality in women with a twin gestation and a short cervix: an updated meta-analysis of individual patient data.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2017Pooled it
- Longitudinal Ultrasound Evaluation of Cervical Length for Predicting Spontaneous Preterm Delivery Before 34 Weeks in Twin Gestations: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Predictive value of a short cervix in the early third trimester for preterm birth in twin pregnancies.BMC pregnancy and childbirth · 2026Article
- Value of serial transperineal ultrasound measurements of cervical length in predicting gestational age at preterm birth in women with twin pregnancies: a retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Ultrasound-Indicated Versus Physical Examination-Indicated Cerclage in Twin Pregnancies Between 24 and 27 + 6 Weeks: An Exploratory Observational Analysis of Pregnancy and Neonatal Outcomes.Journal of pregnancy · 2026Observational
- The impact of COVID-19 infection on the live birth rate in fresh embryo transfer cycles.Frontiers in endocrinology · 2026Article
- Universal cervical-length screening to prevent preterm birth in twin pregnancy: cost-utility analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025Article
- Management of twin pregnancies: Remaining challenges and unanswered questions.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Review
- Early Blood Pressures Warrant Attention in Modern Clinical Data Infrastructure.Hypertension (Dallas, Tex. : 1979) · 2025Article
- ISUOG Practice Guidelines (updated): role of ultrasound in twin pregnancy.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025Article
- Longitudinal Cervical Length Measurements and Spontaneous Preterm Birth in Singleton and Twin Pregnancies.JAMA network open · 2024Article
- Predicting cervical insufficiency in twin pregnancies using ultrasound cervical measurements and elastography.International journal of medical sciences · 2024Article
- Multiple pregnancies, the myometrium and the role of mechanical factors in the timing of labour.Current research in physiology · 2023Article
- Study protocol to quantify the genetic architecture of sonographic cervical length and its relationship to spontaneous preterm birth.BMJ open · 2022Article
- Preterm labor is characterized by a high abundance of amniotic fluid prostaglandins in patients with intra-amniotic infection or sterile intra-amniotic inflammation.The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2021Article
- Personalized assessment of cervical length improves prediction of spontaneous preterm birth: a standard and a percentile calculator.American journal of obstetrics and gynecology · 2021Article
- Cervical Assessment for Predicting Preterm Birth-Cervical Length and Beyond.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundWomen with a twin gestation are at increased risk for preterm birth (PTB), and sonographic cervical length (CL) is a powerful predictor for spontaneous PTB. Obstetricians frequently monitor CL in multiple gestations; yet, the optimal method to integrate and interpret the results of serial sonographic CL has not been determined.
objectiveWe sought to determine whether there are different patterns of cervical shortening in twin gestations, and whether such patterns are related to the risk of PTB. STUDY
designWe conducted a retrospective study of all women with twins followed up in a single tertiary referral center during 2012 through 2014. All women underwent serial measurements of CL every 2-3 weeks starting from 14-18 weeks and until 28-32 weeks of gestation. Changes in CL were analyzed and classified into distinct patterns that were initially identified by visual inspection of all individual cases. Each pattern was then characterized by several parameters including information about when cervical shortening began, the rate of shortening, and whether a plateau was observed. Locally weighted regression mean profiles were generated to describe each pattern of CL over time. The association of these patterns with spontaneous PTB was determined. The specific characteristics of each pattern that further determined the risk of PTB were identified using multivariable logistic regression analysis.
resultsWe studied 441 women who had a total of 2826 measurements of CL done. Overall, 4 main patterns of change in CL were identified: pattern I, stable cervix (n = 196); pattern II, early and rapid shortening (n = 18); pattern III, late shortening (n = 109); and pattern IV, early shortening with a plateau (n = 118). The rate of PTB at <34 weeks was lowest in cases of pattern I (11.7%), followed by pattern IV (14.4%) and pattern III (20.2%), and was highest for women with pattern II (44.4%) (P < .001). In cases with pattern III (late shortening), the most important factors affecting the risk of PTB were the shortening rate, the gestational age at the onset of cervical shortening, and the initial plateau of CL. In the case of pattern IV (early shortening with a plateau), it was only the new plateau at which cervical shortening stopped that was associated with the risk of PTB.
conclusionChanges in sonographic CL over time in twin gestations can be classified into 4 patterns, each associated with a different risk of PTB.
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