The Effect of Polyhydramnios on Cervical Length in Twins
Author Information
Author(s): Neelam Engineer, Keelin O'Donoghue, Ruwan C. Wimalasundera, Nicholas M. Fisk
Primary Institution: Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, London, United Kingdom
Hypothesis
Cervical shortening in polyhydramnios reflects the degree of excess amniotic fluid, and increases with normalization of amniotic fluid volume.
Conclusion
Cervical shortening in twins with polyhydramnios does not appear to be an acute process; cervical length can be measured before or after therapeutic procedures.
Supporting Evidence
- Pre-procedural cervical length correlated with AFI in patients with polyhydramnios.
- Drainage of 2000ml fluid reduced AFI significantly.
- Cervical length did not change significantly at one or 24 hours after amnioreduction.
Takeaway
This study looked at how too much amniotic fluid affects the length of the cervix in pregnant women with twins. It found that even after removing some fluid, the cervix didn't get longer right away.
Methodology
Prospective cohort study of 40 women with monochorionic twins undergoing interventional procedures, assessing cervical length via transvaginal sonography pre-procedure, 1 and 24 hours post-procedure.
Limitations
The study only measured cervical length up to 24 hours post-procedure, which may not capture longer-term changes.
Participant Demographics
Women with monochorionic twins, average maternal age 34 years, with most cases involving twin to twin transfusion syndrome.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI, −0.4 to 0.2
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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