Document Detail


Delivery of the second twin: comparison of two approaches.
MedLine Citation:
PMID:  12128259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare two obstetrical approaches toward delivery of the second twin: one of expectant management, and the other, active; to compare the neonatal and maternal results and thereby identify, if possible, the optimal approach. STUDY DESIGN: This retrospective study looked at twin births in two maternity units in the Paris, France metropolitan region: Antoine Béclère (AB) in Clamart, and Port-Royal (PR) in Paris and concerned 113 deliveries of pairs of twins at AB and 78 at PR. RESULTS: The mean duration of the interbirth interval was 9 min at AB and 5 min at PR (P < 0.001). The characteristics of the pregnancies and the deliveries of twin A were comparable. Spontaneous birth accounted for 51% of twin A births at AB and 27% at PR (P < 0.001). Intrauterine manipulation of twin B occurred in 2% of the births at AB and 43% at PR (P < 0.001). At AB, there were five cesareans to deliver the second twin, but none at PR. The Apgar scores at AB and PR were identical, at 1 and 5 min, and for births before 32 weeks' gestation as well as for those afterwards. At AB, 19% (n = 21) of second twins were transferred to the neonatal intensive care unit, and at PR, 18% (n = 14). CONCLUSION: The neonatal results were similar in both groups, even though both the rate of obstetric maneuvers and the interbirth interval differed significantly. The two methods therefore appear to be equivalent when judged by the second twin's neonatal indicators. Our data suggest that an active approach diminishes the likelihood of cesarean delivery for the second twin, without increasing the neonatal risk.
Authors:
Jean-Claude Pons; Marc Dommergues; Jean-Marc Ayoubi; Marie Gélébart; Emile Papiernik
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  104     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-19     Completed Date:  2003-02-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  32-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Gynecology and Reproductive Medicine, CHU Grenoble, BP 217, 38043 Grenoble, France. jcpons@chu-grenoble.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / statistics & numerical data
Delivery, Obstetric / methods*,  statistics & numerical data*
Diseases in Twins / epidemiology
Female
Humans
Infant Mortality
Infant, Newborn
Infant, Newborn, Diseases / epidemiology
Morbidity
Paris / epidemiology
Pregnancy
Pregnancy Outcome / epidemiology*
Retrospective Studies
Time Factors
Twins / statistics & numerical data*

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