What you need to know to prevent a preterm delivery of twins

I cannot even begin to tell you how many women and men sit in my office and tell me they want twins. However, the reality finally sets in when they see that first sonogram and they realize both the joys and risks ahead of them. Preterm delivery is one of those risks.

Preterm delivery occurs in 12 percent of all pregnancies. In women with twins, this incidence is even higher. It’s also higher if you have had a prior pregnancy with a preterm birth.

Preterm birth is defined as a delivery before 37 weeks of gestation. Complications from prematurity include longer hospitalization, infection, neurological impairment, permanent handicaps and even death.

Many people think that doctors can use medicine or a cerclage – a cervical “stitch” – to prevent preterm labor. In an excerpt from an ACOG Practice bulletin regarding Preterm delivery, formal recommendations about preventative measures are presented:

“Available data regarding the efficacy of cerclage placement, progesterone supplementation, or both for the reduction of preterm birth risk in women with multiple gestations with a short cervical length with or without a prior preterm birth do not support their use.

Cerclage may increase the risk of preterm birth in women with a twin pregnancy and ultrasonographically detected cervical length less than 25 mm and is not recommended.

Progesterone treatment does not reduce the incidence of preterm birth in women with twin or triplet gestations and, therefore, is not recommended as an intervention to prevent preterm birth in women with multiple gestations. Currently, no data are available regarding the efficacy of any other interventions to reduce the risk of preterm birth in women with multiple gestations and a short cervix, and the use of any such alternative measures cannot be recommended outside of formal clinical trials.”

In truth, the only way we can prevent the most common cause of preterm labor and the complications that come from having a baby born prematurely is to prevent twin pregnancies.

The best way to do this is to use IVF to create blastocyst embryos and only transfer one embryo at a time. Luckily, RSC has fantastic pregnancy rates and experience with elective single embryo transfers.