{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:26:51Z","timestamp":1787509611141,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,20]],"date-time":"2019-01-20T00:00:00Z","timestamp":1547942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,4]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Spontaneous preterm birth in women with a twin pregnancy is one of the main causes of perinatal mortality and morbidity. Our aim was to review the perinatal outcome of asymptomatic twin pregnancies with a sonographic short cervical length during the second trimester treated with an ultrasound\u2010indicated cerclage or cervical pessary.<\/jats:p>\n <\/jats:sec>\n \n Material and methods<\/jats:title>\n Retrospective study on asymptomatic twin pregnancies with a short cervix (\u2264\u00a025\u00a0mm) at transvaginal ultrasound examination during the second trimester treated with a cervical cerclage or pessary (2001\u20102017). The rate of preterm birth <\u00a028, 32 and 34\u00a0weeks of gestation, neonatal mortality, neonatal morbidity and composite adverse neonatal outcome were compared in the groups of women treated with cerclage or pessary.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seventy\u2010four twin pregnancies underwent a cerclage while a cervical pessary was inserted in 34 women with twins at our Department: 36 women with an ultrasound\u2010indicated cerclage and 20 with a pessary were included in the analysis. Median gestational age at delivery was higher in women treated with cerclage compared with those with pessary placement (\n P<\/jats:italic>\n \u00a0=\u00a0.02) and the rate of preterm birth before 34\u00a0weeks of gestation was lower in the cerclage group (\n P<\/jats:italic>\n \u00a0=\u00a0.03). Admissions to the Neonatal Intensive Care Unit were more frequent in pregnancies with pessary (\n P<\/jats:italic>\n \u00a0=\u00a0.01), the length of admission was longer (\n P<\/jats:italic>\n \u00a0=\u00a0.005) and composite adverse neonatal outcome occurred more often (\n P<\/jats:italic>\n \u00a0=\u00a0.03) compared with the cerclage group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Ultrasound\u2010indicated cerclage appears to reduce the rate of preterm birth before 34\u00a0weeks of gestation in asymptomatic twin pregnancies with a short cervix during the second trimester, and also the composite adverse neonatal outcome compared with pessary.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aogs.13521","type":"journal-article","created":{"date-parts":[[2018,12,23]],"date-time":"2018-12-23T05:58:28Z","timestamp":1545544708000},"page":"487-493","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The use of ultrasound\u2010indicated cerclage or cervical pessary in asymptomatic twin pregnancies with a short cervix at midgestation"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-0823","authenticated-orcid":false,"given":"Anna","family":"Fichera","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-714X","authenticated-orcid":false,"given":"Federico","family":"Prefumo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Mazzoni","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Molinaris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Zanardini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Fratelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Frusca","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"},{"name":"Department of Obstetrics and Gynecology University of Parma Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Sartori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spedali Civili University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001709"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31829b2dba"},{"issue":"128","key":"e_1_2_9_4_1","first-page":"e1","article-title":"Transvaginal sonographic cervical length for the prediction of spontaneous preterm birth in twin pregnancies: a systematic review and metaanalysis","volume":"203","author":"Conde\u2010Agudelo A","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15668"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)80051-2"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.04.027"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tog.12460"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4643"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2758-3"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2003.017"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-005-0082-2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.7.2011060"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000168435.17200.53"},{"key":"e_1_2_9_16_1","unstructured":"National Institute for Health and Care Excellence. 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