{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:50:44Z","timestamp":1791971444098,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":286,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pregnancy"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Background<\/jats:title>\n Recent advancements in assisted reproductive technology and delayed parenthood have led to a surge in twin pregnancies, with a high incidence of preterm birth (PTB) due to cervical insufficiency. Current guidelines recommend cervical cerclage for twin pregnancies before 24 weeks; however, data on cerclage efficacy beyond 24 weeks is scarce.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This exploratory, hypothesis\u2010generating study is aimed at examining the associations of cervical cerclage on pregnancy duration and neonatal outcomes in twin pregnancies with a short cervix between 24 and 27\u2009+\u20096 weeks.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective cohort study, conducted between July 1991 and July 2023 at Women\u2032s Hospital, Zhejiang University School of Medicine, involved twin pregnancies with a short cervix (\u2264\u200925\u2009mm) during the gestational period ranging from 24 weeks to 27\u2009+\u20096 weeks. Skilled obstetricians performed cervical cerclage. Data on maternal and neonatal outcomes were collected and analyzed using statistical tests, with statistical significance set at\n p<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 73 twin pregnancies were analyzed. Participants were categorized into ultrasound\u2010indicated cerclage group (\n n<\/jats:italic>\n = 22), physical examination\u2010indicated cerclage group (\n n<\/jats:italic>\n = 33), and control group (\n n<\/jats:italic>\n = 18). The ultrasound\u2010indicated cerclage group showed significantly longer presentation\u2010to\u2010birth intervals (60.77 \u00b1 21.64 days,\n p<\/jats:italic>\n = 0.007) and higher birth weights (larger twin: 2273.33 \u00b1 566.09\u2009g,\n p<\/jats:italic>\n = 0.026; smaller twin: 2086.90 \u00b1 526.58\u2009g,\n p<\/jats:italic>\n = 0.029) compared with the control group. No significant differences were found in gestational age at delivery, Apgar scores, cesarean delivery rates, maternal morbidity, and neonatal morbidity among both groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Ultrasound\u2010indicated cerclage in twin pregnancies at 24\u201327\u2009+\u20096 weeks was observed to prolong presentation\u2010to\u2010birth interval and increase birth weight, whereas physical examination\u2010indicated cerclage showed no statistically significant association with the measured outcomes. A randomized controlled clinical trial is needed to validate these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1155\/jp\/2647297","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:10:51Z","timestamp":1791969051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound\u2010Indicated Versus Physical Examination\u2010Indicated Cerclage in Twin Pregnancies Between 24 and 27\u2009+\u20096 Weeks: An Exploratory Observational Analysis of Pregnancy and Neonatal Outcomes"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4110-2735","authenticated-orcid":false,"given":"Peng","family":"Zhao","sequence":"first","affiliation":[{"name":"Assisted Reproduction Unit Department of Obstetrics and Gynecology Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou China zju.edu.cn"},{"name":"Zhejiang Provincial Clinical Research Center for Reproductive Health and Disease Hangzhou China"},{"name":"Zhejiang Key Laboratory of Precise Protection and Promotion of Fertility Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1833-7087","authenticated-orcid":false,"given":"Xiaomin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Women\u2032s Hospital Zhejiang University School of Medicine Hangzhou China zju.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6597-8048","authenticated-orcid":false,"given":"Lidan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Women\u2032s Hospital Zhejiang University School of Medicine Hangzhou China zju.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1414-4043","authenticated-orcid":false,"given":"Lifeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Women\u2032s Hospital Zhejiang University School of Medicine Hangzhou China zju.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1139-0257","authenticated-orcid":false,"given":"Mengyang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Women\u2032s Hospital Zhejiang University School of Medicine Hangzhou China zju.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6739-3345","authenticated-orcid":false,"given":"Jawad","family":"Safdar","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Dow Dental College Dow University of Health Sciences Karachi Pakistan duhs.edu.pk"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1966-458X","authenticated-orcid":false,"given":"Kai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound in Medicine the Fourth Affiliated Hospital of School of Medicine and International School of Medicine International Institutes of Medicine Zhejiang University Yiwu China zju.edu.cn"},{"name":"Key Laboratory of Surface and Interface Science of Polymer Materials of Zhejiang Province School of Chemistry and Chemical Engineering Zhejiang Sci-Tech University Hangzhou China zstu.edu.cn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9877-4797","authenticated-orcid":false,"given":"Maksim","family":"Beluga","sequence":"additional","affiliation":[{"name":"State Institution Republican Scientific and Practical Center \u201cMother and Child\u201d of the Ministry of Health of the Republic of Belarus Minsk Belarus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7384-8460","authenticated-orcid":false,"given":"Ivan","family":"Kurlovich","sequence":"additional","affiliation":[{"name":"State Institution Republican Scientific and Practical Center \u201cMother and Child\u201d of the Ministry of Health of the Republic of Belarus Minsk Belarus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deab029"},{"key":"e_1_2_13_2_2","first-page":"1","article-title":"Births: Final Data for 2022","volume":"73","author":"Osterman M.","year":"2024","journal-title":"National Vital Statistics Reports"},{"key":"e_1_2_13_3_2","article-title":"Guidelines for the Diagnosis, Management and Care of Preterm Birth in Twins (2020 Version)","volume":"36","author":"Committee, 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