Abstract
Objective: To describe second-trimester sonographic changes in cervical morphology and to evaluate their predictive value for spontaneous preterm birth (sPTB) in women with twin pregnancies.
Subjects and methods: In this prospective longitudinal study, 43 women with twin gestations (gestational age 14 - 24 weeks) at Hai Phong University of Medicine Hospital underwent transvaginal ultrasound (TVUS) assessment of cervical length and internal-os morphology at 2-week intervals. Participants were followed until delivery to record obstetric outcomes: term birth, spontaneous preterm birth < 37 weeks and < 34 weeks.
Results: Cervical length decreased progressively with advancing gestational age, described by the linear regression equation y = 44.529 - 0.463·x (r = -0.303). Changes in internal-os morphology were observed in 6/43 patients (14%) after 20 weeks’ gestation. A cervical length cutoff of 35.8 mm predicted sPTB < 37 weeks with sensitivity 72.7%, specificity 84.1% and area under the ROC curve (AUC) = 0.82 (p < 0.001). A cutoff of 33.8 mm predicted sPTB < 34 weeks with sensitivity 75.8%, specificity 75.0% and AUC = 0.79 (p < 0.001). Cervical length < 35.8 mm and < 33.8 mm were associated with increased odds of sPTB < 37 weeks (OR 16.0; 95% CI 7.6 - 26.0) and < 34 weeks (OR 8.0; 95% CI 4.9 - 18.0), respectively. Serial TVUS measurements at 2-week intervals demonstrated mean shortenings of 1.9, 1.2, 1.2, 1.8 and 1.7 mm.
Conclusion: In twin pregnancies between 14 and 24 weeks, cervical length declines progressively. Cervical length thresholds of 35.8 mm and 33.8 mm demonstrate good predictive performance for sPTB < 37 and < 34 weeks (AUCs > 0.7).
| Published | 2025-12-25 | |
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| Issue | Vol. 15 No. 7 (2025) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2025.7.26 | |
| Keywords | chiều dài cổ tử cung, song thai cervical length, twin pregnancies |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2025 Hue Journal of Medicine and Pharmacy
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