Hello, I am 32 weeks pregnant with di-di twins My cervix

Patient

Q: Hello,

I am 32 weeks pregnant with di-di twins. My cervix went from 4.8 cm in 28th week to 3.4 in the 30th week and to 2.7 now. My doctor was on holidays so I don't know how well she did it (I am a MD myself so I know ultrasound needs exact planes and not more or less planes). Anyway she measured 2.7 cm with NO funneling and prescribed modified bed rest and no physical activity. I was doing sports (3x fitness, 1x pilates 1x yoga) and I was only in bed one day and I am going crazy. What would your advice be?

Symptoms:  I have contractions since the 20th week.
Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
Ideally for di-di twins, as you are already in your 32nd week of pregnancy, a cervical length of more than 2.5cm is considered adequate and prevents preterm labour. You may continue yoga and fitness schedule (once) but complete bed rest would not be advisable with these reports at all. I hope antenatal corticosteroids have been administered already to you for foetal lung maturation in case there is a preterm labour. The immediate aim should be 34 weeks and at 36-37weeks, the pregnancy should be terminated else chances of rupture and IUGR further increases. So physical activity may be continued but on a lower scale.
I hope i have answered your query in detail,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: No lung maturation was undertaken or advised, I wasn't even sent to the clinic. Just advised to lay around and stop physical activities. The problem is the longer I lay around the more nervous I get and I have the feeling I get even more contractions this way.
Doctor: Its important that steroids should be given and contractions if occurring then you should be placed on tocolytics daily like isoxsuprine daily to keep the uterus under rest.
Regards

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