Vaginal micronized progesterone and risk of preterm delivery in high-risk twin pregnancies: secondary analysis of a placebo-controlled randomized trial and meta-analysis

2011 ◽  
Vol 38 (3) ◽  
pp. 281-287 ◽  
Author(s):  
K. Klein ◽  
L. Rode ◽  
K. H. Nicolaides ◽  
E. Krampl-Bettelheim ◽  
A. Tabor ◽  
...  
Keyword(s):  
High Risk ◽  
Randomized Trial ◽  
Preterm Delivery ◽  
Meta Analysis ◽  
Secondary Analysis ◽  
Twin Pregnancies ◽  
Micronized Progesterone

Cervical Length as a Predictor of Preterm Delivery in an Unselected Cohort of Women with Twin Pregnancies

2018 ◽  
Vol 36 (12) ◽  
pp. 1288-1294 ◽  
Author(s):  
Clifton O. Brock ◽  
Leslie A. Moroz ◽  
Cynthia Gyamfi-Bannerman
Keyword(s):  
Preterm Delivery ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Cervical Length ◽  
Prospective Data ◽  
Spontaneous Preterm Delivery ◽  
False Discovery ◽  
Twin Pregnancies ◽  
Unselected Cohort

Objective To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. Study Design This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and 24 weeks. Prediction thresholds were determined using a false discovery rate of 10%. The risk of SPTD was compared with previously published, prospective data from a meta-analysis. Results A total of 1,228 women were included. SPTD occurred prior to 35 weeks in 232 (18.9%), 126 (10.3%), and 24 (2.0%) women prior to 35, 32, and 28 weeks. TVCL was most predictive at 22 weeks (area under the curve = 0.67). TVCL thresholds for predicting SPTD prior to 35, 32, and 28 weeks were 3.1, 3.0, and 2.9 cm. Compared with a previous meta-analysis, the risk of SPTD < 34, 32, and 28 weeks was lower (positive likelihood ratio 9.0 vs. 5.4, 10.1 vs. 5.9, and 9.6 vs. 4.3). Conclusion TVCL is modestly predictive of SPTD in twin gestations. Compared with previous prospective studies, this cohort has lower risk of SPTD at similar TVCLs.

scholarly journals Gestational Weight Gain and Its Effects on Maternal and Neonatal Outcome in Women With Twin Pregnancies: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Wei Zhong ◽  
Xiaojiao Fan ◽  
Fang Hu ◽  
Meiqin Chen ◽  
Fanshu Zeng
Keyword(s):  
Weight Gain ◽  
Preterm Delivery ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Weight Status ◽  
Gestational Hypertension ◽  
Meta Analysis ◽  
Gestational Weight ◽  
Increased Risk ◽  
Twin Pregnancies

Background: The incidence of twin pregnancies has risen recently. Such pregnancies are associated with an increased risk for poor maternal and infant outcomes. Gestational weight gain, particularly in singleton pregnancies, has been well-linked with maternal and infant outcomes. The aim of the current meta-analysis was to evaluate the effects of gestational weight gain on maternal and fetal outcomes in women with twin pregnancies.Methods: A systematic search was conducted using the PubMed, Scopus, and Google Scholar databases. Studies, either retrospective or prospective in design, evaluating the effects of gestational weight gain (defined using Institute of Medicine (IOM) guidelines) maternal and/or fetal/neonatal outcomes in women with twin pregnancies were included. Statistical analysis was performed using STATA software.Results: Eleven studies were included in the meta-analysis. Mothers with inadequate weight gain had increased risk for gestational diabetes mellitus (OR 1.19; 95% CI: 1.01, 1.40) and decreased risk for gestational hypertension (OR 0.58; 95% CI: 0.49, 0.68) and cesarean section (OR 0.94; 95% CI: 0.93, 0.96). Neonates born to mothers with inadequate weight gain were susceptible to increased risk for preterm delivery (OR 1.17; 95% CI: 1.03, 1.34), very preterm delivery (gestational age &lt;32 weeks) (OR 1.84; 95% CI: 1.36, 2.48), small for gestational age status (OR 1.41; 95% CI: 1.15, 1.72), low birth weight status (&lt;2,500 g) (OR 1.27; 95% CI: 1.17, 1.38), and neonatal intensive care unit (NICU) admission (OR 1.16; 95% CI: 1.08, 1.24). The pooled findings indicate an increased risk for gestational hypertension (OR 1.82; 95% CI: 1.60, 2.06) and cesarean section (OR 1.07; 95% CI: 1.05, 1.08) among mothers with excessive weight gain. Neonates born to mothers with excessive weight gain were susceptible to increased risk for preterm delivery and very preterm delivery, but were associated with a decreased risk for low birth weight status and small for gestational age status.Conclusions: Gestational weight gain in twin pregnancy, either lower or higher than IOM recommended guidelines, is associated with poor maternal and neonatal outcomes. Our findings call for incorporating counseling on optimal weight gain during pregnancy as part of routine antenatal visits.

Effect of vaginal progesterone in tocolytic therapy during preterm labor in twin pregnancies: Secondary analysis of a placebo-controlled randomized trial

2017 ◽  
Vol 43 (10) ◽  
pp. 1536-1542 ◽  
Author(s):  
Wagner R. Hernandez ◽  
Rossana P.V. Francisco ◽  
Roberto E. Bittar ◽  
Ursula T. Gomez ◽  
Marcelo Zugaib ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Preterm Labor ◽  
Secondary Analysis ◽  
Vaginal Progesterone ◽  
Twin Pregnancies
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