***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Summary . Women attending a twin pregnancy antenatal clinic underwent cervical palpation to calculate a cervical score by subtracting dilatation from length . Those with a score of −2 or less at or before 34 weeks are at especially high risk of preterm labour . A total of 139 such women were r and omly allocated either to receive bed‐rest in hospital or to continue conventional outpatient management .  No beneficial effect of bed‐rest could be identified in prolonging twin pregnancy or improving fetal outcome Summary . A total of 132 twin pregnancies in black African women were studied prospect ively after 30 weeks gestation . Delivery occurred before 37 weeks in 32 % . There was a trend ( 0.1 > P > 0.05 ) towards a higher preterm delivery rate in nullipara ( 57 % ) , in women under the age of 20 years ( 60 % ) and in those with a height/weight ratio of > 2.5 ( 50 % ) . The cervix was assessed with a score based on the length of the canal minus the dilatation of the internal os . In both term and preterm labour there was a significant relation between a cervical score of 0 or a decrease in cervical score and the onset of labour within the subsequent 14 days ( P < 0.001 ) . By these criteria to predict impending labour , 60 % of all labours that ensued within 14 days of the assessment would have been predicted with a 20 % false positive rate . When nulliparae were excluded the predictive value of cervical assessment for preterm labour was 80 % with a false positive rate of < 5 % . Plasma oestriol levels were significanty higher in the preterm labour group but had no clinical prognostic value Nineteen women attending a special multiple pregnancy antenatal clinic with a triplet pregnancy were r and omly allocated to either bed rest in hospital from 24 weeks gestation onwards until delivery , or to continue conventional outpatient management . Conclusions are limited by the trial size , but the study suggests that routine hospitalization for bed rest decreases the incidence of preterm delivery and light-for-gestational age infants and reduces the need for intensive neonatal care . Although still compatible with change variation , the observations , if confirmed in a larger r and omized study , would have considerable implication s for clinical practice . The policy needs further evaluation in a large multicentered collaborative study The study evaluates the benefit of elective hospitalization in preventing premature deliveries of twin gestations . Three groups of women with twin gestations , having no other complications of pregnancy which could cause premature delivery , were evaluated . The study group was comprised of 43 women who were electively hospitalized between 30 - 32 and 36 weeks of gestation . Control group 1 was comprised of 55 women who  were not hospitalized but were instructed to rest at home .  Control group 2 was comprised of 53 women who were not hospitalized and were not instructed to rest at home . Our results showed that  elective hospitalization  did not significantly affect the gestational duration or the prematurity rate . However the mean birthweight difference between the study group and the two control groups were 143 + /- 83 g and 205 + /- 84 g , respectively . This result was more significant in multiparous women . The slight increase in birthweight of the hospitalized women compared to the controls , does not seem to justify the cost of hospitalization OBJECTIVE The purpose of the study was to determine whether the use of prophylactic oral ritodrine or hospitalization for bed rest can prolong pregnancy in multiple pregnancy . METHODS The study was conducted over a period of 8 years and included 189 cases of multiple pregnancy , all of which were delivered at the King Fahd Hospital of the University , Al-Khobar , Saudi Arabia , between July 1986 and August 1994 . The patients were divided into three groups : the first group included 64 patients who received oral ritodrine from the 25th to the end of the 37th week of gestation ; the second group included 57 patients who were hospitalized from the 28th to the 32nd week of gestation ; and the third group , considered the control group , included 68 patients who were managed on an outpatient basis only . Forty-six cases of multiple pregnancy were excluded from the study for a variety of reasons . RESULTS The study showed an increase in gestational age at delivery , an increase in mean birth weight and a reduction in preterm delivery in the group treated with prophylactic ritodrine ( P = 0.03 ) . In the hospitalized group there was no effect on duration of gestation or reduction in preterm delivery , but there was an increase in mean birth weight ( P = 0.04 ) . Several patients experienced troublesome side effects with ritodrine . CONCLUSION Our study indicates that the prophylactic use of beta-sympathomimetics is more effective , beneficial and less expensive than hospitalization for bed rest in prevention of preterm labor and delivery in multiple pregnancy Summary . After admission to hospital for bed rest , 200 women with multiple pregnancies were r and omly allocated to receive either 4 mg of salbutamol orally five times daily , or to receive no drug . After an average of 6 weeks treatment , no difference between the experimental groups could be detected with respect to duration of gestation , birth‐weight or any other of the outcomes of pregnancy observed Objective –To test whether a policy of hospitalization for bed rest , from 28–30 weeks gestation until delivery , lengthens the duration of gestation , improves fetal growth and decreases neonatal morbidity in twin pregnancy Of 141 women with twin pregnancies , 72 were r and omly assigned to outpatient care and 69 to hospital admission between 26 and 30 weeks ' gestation . There were no differences between the groups in the frequencies of major maternal complications in pregnancy and labour but more of those admitted to hospital than of the outpatient group had to be admitted after 30 weeks . There were no differences between the groups in the mean birthweights of the twins by birth order , or in their mean gestation at birth whether analysed by intention to treat or by the treatment given . 22 infants were delivered before 32 weeks ' gestation in the inpatient group compared with 10 in the outpatient group . With the exception of small-for- date s infants , any trend towards greater morbidity or mortality was seen in the inpatient group . The policy of routine hospital admission of women with twin pregnancies from 26 weeks ' gestation is not beneficial to mother or babies and should be ab and oned 212 women with twin pregnancies were r and omly allocated either to receive advice to rest in hospital from 32 weeks ' gestation until delivery , or to be part of a control group in which hospital admission was offered selectively ( and , on average , 5 weeks later ) . Preterm delivery was more common among women admitted routinely for bed rest than among controls , and this difference was unlikely to have occurred by chance . There is at present no scientifically acceptable evidence that this common , disruptive , and expensive obstetric policy does more good than harm 
    Output:
    
Routine bed rest in hospital for multiple pregnancy did not reduce the risk of preterm birth , or perinatal mortality .
No differences were seen in the number of very low birth weight infants .
No support for the policy was found in other neonatal outcomes .
No information is available on developmental outcomes for infants in any of the trials .
The risk of preterm birth was not reduced .
3 ) Analyses of hospitalisation for bed rest in women with a triplet pregnancy .
Most of the comparisons made between the hospitalised and control groups suggest beneficial treatment effects from routine hospitalisation for bed rest .
No differences were seen in the risk of preterm birth , perinatal mortality , fetal growth or in other neonatal outcomes .
REVIEW ER 'S CONCLUSIONS There is currently not enough evidence to support a policy of routine hospitalisation for bed rest in multiple pregnancy .
No reduction in the risk of preterm birth or perinatal death is evident , although there is a suggestion that fetal growth is improved .
For women with an uncomplicated twin pregnancy the results of this review suggest that it may be harmful in that the risk of very preterm birth is increased .