🤰Preterm Labour in Multiple Pregnancies

Why twins don’t always wait…

Not every pregnancy follows the same timeline…

And in multiple pregnancies, nature often decides to act earlier than expected.

🧐Preterm labour is one of the most common and serious challenges in twin and higher-order pregnancies.

In fact, more than 50% of twins are born before 37 weeks.

🤔Why does this happen?

• Uterine overdistension → the uterus is “full” earlier

• Cervical insufficiency → increased pressure on the cervix

• Placental factors (especially in monochorionic twins)

• Higher rates of complications like preeclampsia, anemia, or growth restriction.

💥Who is at higher risk?

• Short cervix (<25 mm)

• Previous preterm birth

• Monochorionic twins

• Rapid uterine growth or symptoms of pressure.

🤗Can we prevent it?

Not always… but we can reduce the risk.

• Regular antenatal follow-up is essential

• Cervical length screening (18–24 weeks)

• Selected cases may benefit from progesterone

• Early recognition of symptoms makes a big difference.

🧨When should we worry?

Any pregnant woman with twins who has:

• Persistent lower abdominal pain or cramps

• Back pain

• Increased vaginal discharge or pressure

• Any bleeding or fluid leakage

→ Should be assessed immediately.

Management is not just about stopping labour…

❤It’s about buying time safely:

• Antenatal corticosteroids for fetal lung maturity

• Tocolysis (short-term when appropriate)

• Magnesium sulfate for neuroprotection (when indicated)

• Timely referral to a facility with NICU support

The key message?

Multiple pregnancies are beautiful… but they are not “routine.”

They require closer care, earlier awareness,

and a team ready to act at the right time.

Because sometimes…

a few extra days inside the womb can change a lifetime.

Dr Rabab Cares 💛

#DrRababCares 

#PretermLabour #TwinPregnancy