Correlation of antepartum uterine activity and cervical change in twin gestation

Abstract

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 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 significant change in the CS was defined as a reduction of at least 0.5 from 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 -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 3/hr represent a risk factor for cervical dilation and/or effacement.