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Re: cervical length in twinsFrom: David Priver, MD (dpriver@aol.com)Thu Jan 29 17:53:20 2004
The only real potential intervention you have to offer at this point is antenatal steroids if there are signs of PTL. I agree that cervical length is pretty much of a seat of the pants phenomenon. I would consider FFN testing starting now and give steroids if positive. DMP At Thu, 29 Jan 2004, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. wrote: > >At Thu, 29 Jan 2004, Charlie Chambers wrote: >> >>Curious how others would manage this patient. 24 year old with twin >>gestation at 28 weeks otherwise no risk factors including no preterm >>deliveries. To date, pregnancy has been uneventful and diamniotic twins >>remain concordant with good growth. Comes in for routine clinic visit. >>She has absolutely no complaints. >> >>Question 1. >>Would you do cervical length measurement routinely? > >No. Who knows what normal cervical lenght is for twin gestation at 28 >weeks, I don't and I make it a point not to order a test if I don't know >what the normal value is and how to act on it. >> >>Question 2. >>If done, and measurement is 1-1.5 cm, and patient still denies >>contractions, what would you do? > >Nothing as I tell all twin Mom's that they are at risk for premature >delievery. > >>Question 3. >>You are in a small hospital that handles 36 weeks and greater, would >>you transfer care immediately if upon digital exam, she is found to be >>1 cm dilated? > >Only 1 cm we should be so lucky, but in all seriousness tranfer would >depend how close the nearest high risk center is and how the patient >feels about all this. I would give her some celestone and ask for a >consult from a perinatologist at the center she would be transfered to >in the event she did go into prem labour. > >-- > Take care, John >
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