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• W2129306002 abstract "Research has shown that a long cervix in mid-pregnancy increases the risk of cesarean delivery at term in nulliparous women (Smith et al, NEJM 2008). The aim of this study was to identify factors that can predict the mode of delivery in women with a multiple pregnancy who are not delivered by elective caesarean section. This was a secondary analysis of a trial on progesterone treatment for the prevention of preterm birth in multiple pregnancies (the AMPHIA trial, ISRCTN40512715). Women who had an elective cesarean section were excluded from this analysis. We performed a univariable analysis for the risk of emergency cesarean section using age, BMI, ethnicity, education level, parity, smoking, alcohol use, fertility treatment, number of multiples, chorionicity and cervical length. The final predictors of the multivariable models were identified by backward stepwise selection using Akaike's Information Criterium. The model was validated by bootstrapping techniques and shrinkage. Performance of the model was assessed in terms of calibration and discrimination. Of 528 women, 119 (23%) delivered by cesarean section. The only variable related to cesarean section in univariable analysis was nulliparity (OR 1.9; 95% CI 1.2 to 2.9). Backward stepwise selection yielded that a triplet pregnancy (OR 3.2; 95% CI 0.6 to 16.5) and non-Caucasian ethnicity (OR 1.5; 95% CI 0.8 to 2.8) were independent predictors of cesarean section as well. Calibration was good and the discriminative performance of the model was moderate (c-statistic 0.60: 95% CI 0.55 to 0.65). Cervical length in the second trimester did not have an effect on mode of delivery (OR 1.0; 95% CI 0.96 to 1.01). This remained true when the analysis was confined to nulliparous women who delivered after 34 weeks of gestation. Nulliparity, triplet pregnancy and non-Caucasian ethnicity increase the risk of emergency cesarean section in women with a multiple pregnancy. In our study population, mid-pregnancy cervical length does not seem to influence the risk of an emergency cesarean section in multiple pregnancies." @default.
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• W2129306002 date "2011-01-01" @default.
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• W2129306002 title "99: Mid-pregnancy cervical length and the risk of cesarean delivery in multiple pregnancies" @default.
• W2129306002 doi "https://doi.org/10.1016/j.ajog.2010.10.115" @default.
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