Twins and preterm labor
Rust, O.A.; Perry, K.G.; Andrew, M.E.; Roberts, W.E.; Martin, R.W.; Morrison, J.C.
Journal of Reproductive Medicine 42(4): 229-234
1997
ISSN/ISBN: 0024-7758 PMID: 9131496 Document Number: 477488
OBJECTIVE: To assess the effect of home uterine contraction assessment (HUCA) in twin pregnancies with preterm labor (PTL) at lt 24 weeks' gestation. STUDY DESIGN: In this retrospective, analytic study, patients were stratified by whether HUCA had been prescribed before or after diagnosis of PTL. The main outcomes studied were time of PTL diagnosis and delivery as well as birth weight and need for neonatal intensive care unit (NICU) admission. In 63 patients, 32 were prescribed HUCA after PTL had been arrested at lt 24 weeks (group I). Thirty-one women had HUCA prescribed at 20 weeks' gestational age and then developed PTL at lt 24 weeks (group II). RESULTS: Labor was diagnosed at similar times in both groups (22.8 vs 23.4 weeks), but delivery was earlier in group I (27.6 weeks vs. 24.7 weeks) than in group II. The birth weight in group I was less (918 +- 255 g), and of the 64 infants, 55 required NICU admission as compared to 2,340 +- 525 g and 11 of 62 infants (P lt .0001, .0001) in group II, respectively. CONCLUSION: Women with twin gestations and the diagnosis of PTL prior to 24 weeks deliver later in gestation, and their infants weigh more and have fewer NICU admissions if intensive prenatal surveillance is prescribed prior to the onset of labor.