{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:40:33Z","timestamp":1792644033317,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,1,28]],"date-time":"2018-01-28T00:00:00Z","timestamp":1517097600000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Obstetric &amp; Gynaecologis"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Key content<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Twin pregnancies are associated with a three\u2010fold greater perinatal mortality than singleton pregnancies. Prematurity is a main contributor, with 50% of twin pregnancies delivering before 37\u00a0weeks and 10% delivering before 32\u00a0weeks of gestation.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The aetiology of preterm delivery in twin pregnancies is likely multifactorial and different from that of singletons.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Cervical cerclage reduces preterm birth rates in singletons but has mixed results in twins with some studies showing harm.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The use of progesterone to prevent preterm birth in singletons has conflicting results and has not been proven to prevent preterm birth in twins. Studies continue to determine whether the cervical pessary is effective in preventing preterm birth in multiple pregnancies.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>There is a paucity of data available on the prevention of preterm birth in triplets\/higher order multiples but similar principles to twin pregnancy\u00a0apply.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Learning objectives<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>To review the burden of preterm birth in multiple pregnancy.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>To understand the methods available for preventing preterm birth in multiple pregnancies and the evidence surrounding the use of each one.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>To be aware of the use of the Arabin pessary.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/tog.12460","type":"journal-article","created":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T19:06:07Z","timestamp":1517252767000},"page":"57-63","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Spontaneous preterm birth prevention in multiple\u00a0pregnancy"],"prefix":"10.1111","volume":"20","author":[{"given":"Sarah R","family":"Murray","sequence":"first","affiliation":[{"name":"MRC Centre for Reproductive Health Queen's Medical Research Institute University of Edinburgh Edinburgh EH16\u00a04TJ UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J","family":"Stock","sequence":"additional","affiliation":[{"name":"MRC Centre for Reproductive Health Queen's Medical Research Institute University of Edinburgh Edinburgh EH16\u00a04TJ UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shona","family":"Cowan","sequence":"additional","affiliation":[{"name":"Royal Infirmary Edinburgh Edinburgh EH16\u00a04SA UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth Sarah","family":"Cooper","sequence":"additional","affiliation":[{"name":"Royal Infirmary Edinburgh Edinburgh EH16\u00a04SA UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E","family":"Norman","sequence":"additional","affiliation":[{"name":"MRC Centre for Reproductive Health Queen's Medical Research Institute University of Edinburgh Edinburgh EH16\u00a04TJ UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,28]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Multiple pregnancy: antenatal care for twin and triplet pregnancies","author":"National Institute for Health and Care Excellence","year":"2011"},{"key":"e_1_2_6_3_1","volume-title":"Special care nursery admissions","author":"National Perinatal Information System Quality Analytical Services, March of Dimes","year":"2011"},{"key":"e_1_2_6_4_1","volume-title":"Multiple failings; parents\u2019 of twins and triplets experience of pre and post natal NHS care","author":"Fraser E.","year":"2009"},{"key":"e_1_2_6_5_1","volume-title":"MBRRACE\u2010UK Perinatal Mortality Surveillance Report. 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