Asymptomatic twin pregnancies with newly short cervix at 24-276/7 weeks' gestation based on dynamic series follow-up findings: is cervical cerclage necessary?

Purpose: To explore the safety and efficacy of cervical cerclage for asymptomatic twin pregnancies with a newly diagnosed short cervix between 24 and 27^6/7 weeks' gestation.

Methods: Eighty-six pregnant women with asymptomatic twin pregnancies and a newly diagnosed short cervix at 24-27^6/7 gestational weeks were divided into two groups based on receipt of ultrasound-indicated cerclage (UIC). The primary outcome was gestational age at birth. Secondary outcomes included spontaneous preterm birth (sPTB) rates and neonatal outcomes.

Results: Forty-seven participants received UIC and 39 comprised the control group. The UIC group demonstrated a significantly prolonged diagnosis-to-birth interval, higher gestational age at birth, improved ongoing pregnancy survival curve, and lower risk of sPTB at <36, 34, 32, 30, and 28 weeks compared to controls. Neonates in the UIC group had higher birth weights, lower risk of birth weight <1500 g, and reduced neonatal intensive care unit (NICU) admission rates.

Conclusion: UIC performed at 24-27^6/7 weeks for asymptomatic twin pregnancies with a newly diagnosed short cervix can prolong gestation, reduce severe sPTB, and improve short-term perinatal outcomes.