Review Article

Cervical Length Measurement for the Prediction of Preterm Birth in Symptomatic Women with a Twin Pregnancy: A Systematic Review and Meta-Analysis

Table 1

Study characteristics.

StudyInclusion criteriaExclusion criteria Gestational age at testing (wk)CL at inclusionCL cutoff (mm)OutcomeDesignRepresentative spectrum of patientsAdequate description of test procedurePractitioner blinded to measurement resultsReporting on study withdrawals

FuchsTwins, regular and painful uterine contractionsCervical cerclage, ruptured membranes, and dilatation >3 cm8724–3620 mm (1–45)
Median (IQR)
25Delivery within 7 daysProspective cohortYesYesNoYes

Crane Twins, regular uterine contraction with cervical dilatation, effacement, and/or change in consistency Cervical cerclage, placenta previa, ruptured membranes, vaginal bleeding, dilatation >3 cm, and stillbirth2623–3325 mm (14.0)
Mean (SD)
30Preterm birth <34 and <37 weeksProspective cohortYesYesNoNo

Gonzalez Twins, regular uterine contraction with cervical changes (effacement of at least 50% or dilatation of at least 1 finger)Cervical cerclage, maternal or fetal contraindication to continue pregnancy66<34Not reported20, 30Preterm birth <34 and <37 weeksProspective cohortYesYesNoNo

Venditelli Twins, regular uterine contraction, and/or cervical effacement or dilatationCerclage, fetal anomalies, placenta previa, ruptured membranes, vaginal blood loss, dilatation >3 cm, stillbirth, and delivery <24 weeks after admission2618–36Not reported30Preterm birth <37 weeksProspective cohortYesYesYesYes

YoshizatoTwins, regular uterine contraction with cervical dilatation, effacement, and/or change in consistency TTTS, uterine anomalies, conization, vaginal blood loss, PE, hypertension, diabetes, and history of PTB2116–3522 mm (5.5)
Mean (SD)
25Preterm birth <34 and <37 weeksProspective cohortYesYesNoNo