![]() ![]() ![]() ![]() Your cervix is likely effacing, or dilating, or both to get ready for the big day. It is, after all, one of the main lines of defense between your womb and the outside world. Losing your mucus plug usually means that your body is preparing for labor. This information "will complement the ongoing national and international efforts to reduce the rates of stillbirths and unexpected neonatal complications in babies born near term," they conclude.How Long After You Lose Your Mucus Plug Do You Go Into Labor? The authors point out that the actual risk of stillbirth near term "might be higher than reported estimates because of the policy of planned delivery in twin pregnancies." But say, "our study provides comprehensive estimates comparing risks of stillbirth and neonatal mortality at various gestational ages, which is required for the planning of delivery in uncomplicated twin pregnancies." In monochorionic twin pregnancies, "there is no clear evidence to support routine delivery before 36 weeks' gestation," they say. Rates of neonatal morbidity (including respiratory distress syndrome, septicaemia, or neonatal seizures) and admission to the neonatal intensive care unit showed a consistent reduction with increasing gestational age in both monochorionic and dichorionic pregnancies.īased on these estimates, the researchers suggest that, for women with dichorionic twin pregnancies, delivery should be considered at 37 weeks' gestation "to prevent the significant increase in stillbirths associated with expectant management compared with the risk of neonatal deaths associated with early delivery." But more data are needed to make a clear recommendation on best time to deliver monochorionic pregnancies. In monochorionic pregnancies, the risk of stillbirth appears to be higher than neonatal death beyond 36 weeks' gestation. However, delay in delivery by a week (to 38 weeks) led to an additional 8.8 deaths per 1,000 due to an increase in stillbirth. ![]() They found that, in dichorionic pregnancies, the risk of stillbirths and neonatal death were balanced until 37 weeks' gestation. The researchers looked specifically at the balance between the risk of stillbirths from expectant management ('watchful waiting') and the risk of neonatal death from delivery beyond 34 weeks. Study design and quality were taken into account to minimise bias. Overall the studies included 35,171 twin pregnancies (29,685 dichorionic and 5,486 monochorionic). They analysed the results of 32 studies, published within the past 10 years, of women with uncomplicated twin pregnancies that reported rates of stillbirth and neonatal mortality (defined as death up to 28 days after delivery) at various gestational ages after 34 weeks. So an international team of researchers decided to examine the evidence behind these recommendations. Uncomplicated twin pregnancies are often delivered early in an attempt to prevent stillbirth, but the optimal gestational age for delivery that minimises risks to newborns is not known.Ĭurrent recommendations vary on the timing of delivery, starting from 34 up to 37 weeks' gestation in monochorionic twin pregnancies (twins that share the same placenta) and from 37 up to 39 weeks in dichorionic twin pregnancies (twins that have two individual placentas). It is well known that the risk of stillbirth is higher in twin pregnancies than in singleton pregnancies. ![]()
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