Preterm Delivery of Twins

The incidence of twin gestation has increased over the past decades and contributes to an increased rate of spontaneous preterm birth and increased mortality and morbidity up to adult age. Prevention of spontaneous preterm birth in twin pregnancies differs from interventions in singleton pregnancies.

Up to now, many treatment modalities have been investigated such as bed rest, tocolytics, antibiotics, cerclage or progestagens, but have failed to prevent prematurity rates in twin gestations or were even combined with harmful effects. Cervical pessaries might be a non-invasive cost-effective option, but it is mandatory to evaluate vaginal progesterone and cervical pessaries in twin gestations with a short cervix in further randomized trials.