Twins & Triplets – New Method

The incidence of twin and triplet pregnancies has increased in recent years mainly due to the increase of couples seeking assisted reproduction technologies (in vitro fertilization, intrauterine insemination, ovulation induction). This results in the increase in the number of premature deliveries and babies.

In the period between 2003 and 2012 we performed a study to improve the perinatal and postnatal outcome of multiple pregnancies. A prophylactic vaginal cerclage was applied in twin and triplet pregnancies using a modified Shirodkar technique. The results were very encouraging and the study was published in the scientific journal: ‘Journal of Clinical Gynecology and Obstetrics’, issue 2(2), September 2013.

With this method the suture is completely embedded in order to avoid the risk of infection, chorioamnionitis and premature rupture of membranes. In the 31 twin pregnancies studied, the average gestational age was 35+4 weeks and the average weight of the neonate was 2267g. These values were higher than those reported in other studies at 33+6 weeks and 1969.15g.

In the triplet pregnancies the average gestational age was 33+6 weeks and the average neonatal weight was 1814.67g. Other studies have reported gestational age at 29+5 weeks and weight at 1309g for triplet pregnancies.

In our study, the placement of the suture increased the average gestational age and the neonatal weight in multiple pregnancies. This decreases the chances of premature labour, the time needed in the neonatal care intensive unit and the chance of perinatal mortality and morbitity. Only one baby was born with very low birth weight, under 1500g (1240g), which corresponds to 1.6% of our twin pregnancies. This percentage was much lower than 9.7% and 15% reported in other studies. In our triplet pregnancies we had no babies with extremely low birth weight (less than 1000g) even though this is something reported in other studies. All women were active and able to avoid bed rest during their pregnancies and thus avoided all the psychological issues associated with it.

For more information, please read our published article at the Journal of Clinical Obstetrics and Gynecology (2013).


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