Excessive uterine contractions : effect on the incidence of preterm delivery in twin gestation

OBJECTIVE: To evaluate the effect of uterine contractions on the incidence of preterm delivery within 7 and 14 days in twin pregnancies. STUDY DESIGN: Study patients were identified from a large database composed of women receiving outpatient surveillance with home uterine contraction monitoring. We included tracings collected on a routine or acute basis from twin pregnancies without cerclage at 24.0-36.0 weeks. Tracings from patients with indicated delivery were excluded. Fisher's exact and Pearson's X2 tests were used. RESULTS: Datafrom 2,423 patients who recorded 8,291 acute tracings and 12,649 routine tracings were analyzed. Preterm delivery within 7 days followed 1.4% of routine vs. 6.6% of acute tracings (p <0.001). Preterm delivery within 14 days followed 5.1% of routine vs. 16.8% of acute tracings (p <0.001). CONCLUSION: Preterm uterine contractions affect pregnancy prolongation and outcome in twin pregnancies utilizing outpatient surveillance. Evaluation of patients exhibiting elevated preterm uterine contractions is warranted.