Preterm Labor Surveillance in Multiple Gestations
One common complication of carrying multiples is preterm labor and delivery. The average length of pregnancy is 35 weeks for twins, 32 weeks for triplets, and 29 weeks for quadruplets. Even though 35 weeks is reassuring, twins are 10 times more likely, and triplets 30 times more likely, than singletons to deliver very premature (less than 32 weeks). It is this group of early babies that account for the majority of long term complications of premature delivery.
One way to combat the complications of a premature delivery is early recognition of those pregnancies at highest risk for preterm delivery. Early recognition affords the opportunity to be prepared for, and sometimes prevent, premature delivery. Multiple studies have shown that transvaginal ultrasound measurement of the lower segment of the womb (an area called the cervix) can help identify women at risk of delivering early. In addition, the presence of special proteins in vaginal fluid secretions (a substance call fetal fibronectin) can also pinpoint those pregnancies at risk of early delivery.
Here at Ochsner's Multifetal Pregnancy Center of New Orleans, our Maternal Fetal Medicine physicians utilize innovative cervical length surveillance protocols, along with periodic fetal fibronectin screening, to help identify those women at risk for preterm labor. Our physicians measure the cervix with high-definition transvaginal ultrasound every two weeks from 16 to 28 weeks of pregnancy and perform fetal fibronectin screening on all women with signs and symptoms of preterm labor. If shortening of the cervix is identified or if fetal fibronectin is detected, multiple interventions, including steroid administration, administration of anti-contraction medications and even surgical stitching of the uterus (a procedure called a cerclage) may be employed to prevent early delivery.