Document Detail

Correlation of antepartum uterine activity and cervical change in twin gestation.
MedLine Citation:
PMID:  9298154     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the correlation between quantitative measurements of antepartum uterine activity and cervical change twin gestations. METHODS: Forty women from our Twin Clinic constituted the study group. Participants had a cervical examination each week between 20 and 37 weeks gestation and a cervical score (CS) was calculated as follows: CS = cervical length (cms)-cervical dilation (cms) at the internal os. The women also performed blinded home uterine activity monitoring (HUAM) for a mean of 7.0 + 3.0 hrs/wk (+SD). Uterine activity was expressed as mean number of contractions/hour/week gestation based on the average of three independent reviewers. CS was determined by a single clinician unaware of the HUAM recordings. A significant change in the CS was defined as a reduction of at least 0.5 from the preceding week. Correlation coefficients were used to determine the association between uterine activity and change in the cervical score. RESULTS: Twin pregnancy was characterized by a rise from 0.2 + .03 contractions/hr at 20 weeks to 3.2 + 2.4 contractions/hr at 37 weeks gestation. CS fell from a mean of 2.6 + 0.2 at 20 weeks to -2.1 + 0.9 at 37 weeks gestation. There was a significant negative correlation (-0.317, p < .0001) between increasing uterine activity and decreasing CS. There were significantly more (p < .002) contractions during the 7 days preceding a significant reduction in CS (3.3 + 3.5 contractions/hr) than when the CS was unchanged (1.6 +/- 1.5 contractions/hr). CONCLUSIONS: In twin gestations, an increasing frequency of uterine contractions is strongly correlated with quantifiable cervical change between 20-37 weeks gestation. Persistent daytime contraction frequencies of > 3/hr represent a risk factor for cervical dilation and/or effacement.
R B Newman; J M Ellings; M M O'Reilly; B C Brost; M C Miller; D Gates
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta geneticae medicae et gemellologiae     Volume:  46     ISSN:  0001-5660     ISO Abbreviation:  Acta Genet Med Gemellol (Roma)     Publication Date:  1997  
Date Detail:
Created Date:  1997-11-13     Completed Date:  1997-11-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370314     Medline TA:  Acta Genet Med Gemellol (Roma)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, USA.
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MeSH Terms
Cervix Uteri / physiology*
Obstetric Labor, Premature*
Pregnancy, Multiple*
Uterine Contraction / physiology*

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