Delivery of the second twin: influence of presentation on neonatal outcome, a case controlled study

BMC Pregnancy and Childbirth
Gerhard BognerVolker R Jacobs

Abstract

Spontaneous vaginal twin delivery after 32nd week of gestation is safe when first twin presenting cephalic. Aim of this study is to identify obstetric factors influencing the condition of second twin and to verify whether non-cephalic presentation and vaginal breech delivery of the second twin is safe. This is a retrospective case controlled cohort study of 717 uncomplicated twin deliveries ≥32 + 0 weeks of gestation from 2005 to 2014 in two tertiary perinatal centers. Obstetric parameters were evaluated in three groups with descriptive, univariate logistic regression analysis for perinatal outcome of second twins. The three groups included twins delivered by elective cesarean section ECS (n = 277, 38.6%), by unplanned cesarean section UPC (n = 233, 32.5%) and vaginally (n = 207, 28.9%). Serious adverse fetal outcome is rare and we found no differences between the groups. Second twins after ECS had significant better umbilical artery UA pH (p < 0.001) and better Apgar compared to UPC (p = 0.002). Variables for a fetal population "at risk" for adverse neonatal outcome after vaginal delivery (UA pH < 7.20, Apgar 5´ < 9) were associated with higher gestational age (p = 0.001), longer twin-twin interval (p = 0.05) and vacuum extrac...Continue Reading

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Citations

Nov 28, 2018·World Journal of Gastroenterology : WJG·Garett DunsmoreShokrollah Elahi
Jul 10, 2020·Archives of Gynecology and Obstetrics·Misgav RottenstreichOri Shen
Oct 9, 2020·American Journal of Perinatology·Jenny Y MeiYalda Afshar
Nov 23, 2020·Archives of Gynecology and Obstetrics·Sabine EnenglRichard Bernhard Mayer

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Methods Mentioned

BETA
cesarean section
C-section
cesarean

Software Mentioned

SPSS

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