Document Detail


Delivery of the nonvertex second twin: breech extraction versus external cephalic version.
MedLine Citation:
PMID:  7485286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to compare the maternal and perinatal outcomes of twin gestations in which the nonvertex second twin was delivered by total breech extraction versus those delivered by external cephalic version. STUDY DESIGN: The intrapartum courses of 284 consecutive twin gestations were analyzed retrospectively. Once those with actual birth weight < 600 gm, unrecognized multifetal pregnancy, multiple congenital anomalies, cesarean delivery, and/or antepartum intrauterine fetal death were excluded, 23 mothers were delivered by total breech extraction and 21 underwent external cephalic version. RESULTS: The two groups were similar for mean (+/- SD) maternal age, gravidity, parity, gestational age at delivery, ultrasonographic estimate of birth weight for twin B, incidence of breech or transverse presentation for the second fetus, and actual birth weight of the first or second newborn. Suspected fetal distress that led to cesarean delivery occurred significantly more often in parturients who underwent attempted external version (4/21) than total breech extraction (0/23, p = 0.04). The incidence of eventual abdominal delivery was also significantly higher in patients who underwent attempted external cephalic version (10/21) rather than breech extraction (1/23, p = 0.001). For twin B the occurrence of low Apgar scores at 1 minute was significantly higher for infants after attempted external version (7/21) rather than breech extraction (1/23, p = 0.02), but the mean pH, number with Apgar scores < 7 at 5 minutes, and number of neonatal intensive care unit admissions were similar. No perinatal traumatic injury occurred in either group. CONCLUSION: On the basis of our experience, total breech extraction of the nonvertex second twin is preferable to external cephalic version because it appears to be associated with a significantly lower incidence of fetal distress and abdominal delivery with comparable neonatal outcome.
Authors:
S P Chauhan; W E Roberts; R A McLaren; H Roach; J C Morrison; J N Martin
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  173     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-12-05     Completed Date:  1995-12-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1015-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Apgar Score
Breech Presentation*
Cesarean Section
Extraction, Obstetrical*
Female
Humans
Pregnancy
Pregnancy Outcome
Pregnancy, Multiple*
Retrospective Studies
Twins*
Version, Fetal*
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 1996 Sep;175(3 Pt 1):750-1   [PMID:  8828448 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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