KẾT CỤC THAI KỲ CỦA CÁC SẢN PHỤ SONG THAI QUẢN LÝ THAI TẠI BỆNH VIỆN ĐẠI HỌC Y HẢI PHÒNG

Abstract

Objective: To describe pregnancy outcomes in women with twin pregnancies who received antenatal care and management at Hai Phong University of Medicine and Pharmacy Hospital.

Materials and Methods: A prospective longitudinal cohort study was conducted on 100 women with twin pregnancies at 14-24 weeks of gestation, managed at Hai Phong University of Medicine and Pharmacy Hospital from 2023 to 2025. Transvaginal ultrasound was performed serially at 16, 18, 20, 22, and 24 weeks to measure cervical length and uterocervical angle.

Results: The majority of participants were under 35 years of age (75%). Most pregnancies were conceived via assisted reproductive technology (72%), and the predominant type was dichorionic diamniotic twins (85%). Preterm birth prophylaxis was applied in 51% of cases, including cervical cerclage (20%), combined tocolysis and hormonal therapy (17%), and hormonal therapy alone (12%). Pregnancy complications included threatened preterm labor (51%), polyhydramnios (17%), and preeclampsia (7%), with severe preeclampsia in 4 cases (4%). Only one monochorionic twin pregnancy was complicated by fetal growth restriction. The mean gestational age at delivery was 35.83 ± 2.135 weeks, with term delivery and late preterm birth rates of 67% and 21%, respectively. Adverse outcomes included early preterm birth <34 weeks (12%), severe preeclampsia (4%), and neonatal death (3%). Factors significantly associated with early preterm birth were second-trimester cervical length <31.9 mm (OR = 5.37, p < 0.001) and internal os funneling (Y- or U-shaped) in the second trimester (OR = 3.16, p = 0.02).

Conclusion: Early preterm birth is the most common adverse outcome in twin pregnancies. Cervical morphological changes, particularly shortened cervical length and internal os funneling, are significantly associated with this complication.