RISKS OF ANTEPARTUM CERVICAL EXAMINATION IN MULTIFETAL GESTATIONS

OBJECTIVE: This study was performed to determine the risks associated with antepartum cervical examination in women with multifetal gestations attending a specialized antepartum Twin Clinic. STUDY DESIGN: Patients followed up in a specialized Twin Clinic from 1988 through 1991 (N = 89) received extensive preterm birth prevention education and routine cervical examination at each clinic visit. Obstetric outcome was compared between these patients and 288 other twin gestations followed up in the high-risk obstetric clinics between 1981 and 1991. In these control twin gestations cervical examination was done for obstetric indications only. RESULTS: Comparisons between the 89 Twin Clinic attendees and the 288 controls followed up in the high-risk obstetric clinic revealed no significant differences in patient demographics, medical complications, or infectious morbidity. Importantly, premature rupture of membranes was significantly less frequent in the Twin Clinic group, who had 7.6 +/- 3.2 (mean +/- SD) cervical examinations per patient. CONCLUSION: Routine cervical examination in multifetal gestations is not associated with increased rates of premature rupture of membranes or other obstetric complications.