The relationship between placental histology and cervical length in twin gestations

Objective: To evaluate differences in placental lesions in twin pregnancies with and without mid-trimester sonographic cervical shortening. Methods: Two groups of women were identified: those with twin gestations and a cervical length <= 2.5 cm measured between 16 and 24 weeks of gestation and those with twin gestations and without evidence of cervical shortening. The placental pathology was then retrospectively reviewed. The placental lesions were categorized as either acute or chronic inflammatory lesions, lesions of malperfusion or coagulopathic lesions. Results: A total of 704 patients with twin gestations were identified. There was significantly more acute chorioamnionitis in patients with cervical shortening but no differences in the frequency of other placental lesions. Conclusion: Placentas with acute inflammatory lesions are significantly more frequent in twin gestations with mid-trimester cervical shortening.