Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies

Su Jin Sung, Seung Mi Lee, Sohee Oh, Joo Hee Choi, Jee Yoon Park, Byoung Jae Kim, Joon Ho Lee, Chan Wook Park, Joong Shin Park, Jong Kwan Jun

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


It is well known that a short cervix at mid-pregnancy is a risk factor for spontaneous preterm birth in both singleton and twin gestations. Recent evidence also suggests that a long cervix at mid-pregnancy is a predictor of the risk of cesarean section (C/S) in singleton gestation. The purpose of this study was to determine whether a long cervix at mid-pregnancy was associated with an increased risk of C/S in women with twin pregnancies. We enrolled 746 women pregnant with twins whose cervical length was measured by trans-vaginal ultrasonography at a mean of 22 weeks of gestation and who delivered in our institution. Cases with a short cervix [cervical length (CL) <15 mm] were excluded. Cases were divided into four groups according to the quartile of CL. The rate of C/S increased according to the quartile of CL (47% in the 1 st quartile, 51% in the 2 nd quartile, 56% in the 3 rd quartile and 62% in the 4 th quartile, P<0.005, χ 2 for trend). CL was an independent risk factor for C/S even after adjustment for confounding variables. When confining analysis to women who delivered after a trial of labor (n=418), to nulliparous women (n=633) or to those who delivered at late preterm or full term (n=666), the rate of C/S also increased according to the quartile of CL, and the relationship between CL and the risk of C/S remained significant after adjustment in each group. In women pregnant with twins, long CL at mid-pregnancy was a risk factor for C/S.

Original languageEnglish
Pages (from-to)780-785
Number of pages6
JournalJournal of Perinatal Medicine
Issue number7
Publication statusPublished - 2018 Sept 25

Bibliographical note

Funding Information:
Acknowledgment: This work was supported by a multidisciplinary research grant-in-aid from the Seoul Metropolitan Government Seoul National University (SMG-SNU) Boramae Medical Center (02-2015-4).

Publisher Copyright:
© 2018 Walter de Gruyter GmbH, Berlin/Boston.

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology


Dive into the research topics of 'Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies'. Together they form a unique fingerprint.

Cite this