Neonatal outcome of very preterm twins: policy of planned vaginal or cesarean delivery

American Journal of Obstetrics and Gynecology
Loïc SentilhesGilles Kayem

Abstract

The objective of the study was to compare neonatal mortality and morbidity in very preterm twins with the first twin in cephalic presentation in hospitals with a policy of planned vaginal delivery (PVD) and those with a policy of planned cesarean delivery (PCD). Women with preterm cephalic first twins delivered after preterm labor and/or premature preterm rupture of membranes from 26(0/7) to 31(6/7) weeks of gestation were identified from the databases of 6 perinatal centers and classified as PVD or PCD according to the center's management policy from 1999 to 2010. Severe neonatal morbidity was defined as any of the following: intraventricular hemorrhage grades 3-4, periventricular leukomalacia, necrotizing enterocolitis, bronchopulmonary dysplasia, and hospital death. The independent effect of the planned mode of delivery, defined by the center's management policy, was tested and quantified with a 2-level multivariable logistic regression. The PVD group included 248 women, and the PCD group 63. Maternal characteristics did not differ between the 2 groups. The rate of vaginal delivery was 85.9% (213 of 248) vs 20.6% (13 of 63) (P < .001), and the rate of cesarean delivery for the second twin was 1.6% (4 of 248) vs 4.8% (3 of 63...Continue Reading

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Citations

May 10, 2017·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·G C Di RenzoG H A Visser
May 24, 2016·Obstetrics and Gynecology·Loïc SentilhesGilles Kayem
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Sep 15, 2018·BJOG : an International Journal of Obstetrics and Gynaecology·E LortheUNKNOWN EPIPAGE-2 Obstetric Writing Group
Jan 5, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Ben W MolMarjolein Kok
Dec 12, 2018·Obstetrics and Gynecology·Loïc SentilhesUNKNOWN Etude Epidémiologique sur les Petits Ages Gestationnels (EPIPAGE) 2 Obstetric Writing Group
Nov 5, 2016·Journal of Perinatal Medicine·Katja BriceljIsaac Blickstein
Dec 26, 2019·Archives of Gynecology and Obstetrics·Alexander JardeSarah Diana McDonald
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Aug 29, 2021·American Journal of Obstetrics & Gynecology MFM·Amir AviramElad Mei-Dan

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