| Effect of twin-to-twin delivery interval on umbilical cord blood gas in the second twins. | |
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MedLine Citation:
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PMID: 11843376 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine the effect of twin-to-twin delivery interval on the umbilical cord blood gas status of the second twin following vaginal delivery. DESIGN: A retrospective study. SETTING: The department of obstetrics and gynaecology in a university teaching hospital. POPULATION: Twin deliveries at or beyond 34 weeks of gestation over a period of five years, with the first twin delivered vaginally. Twins with any antepartum complications including discordant growth, intrauterine growth restriction, intrauterine death, fetal malformations and pre-eclampsia were excluded. METHODS: The correlation between the twin-to-twin delivery interval, and both the umbilical arterial and venous blood gas parameters of the second twin, including pH, partial pressure of CO2 and base excess, were studied. RESULTS: A total of 118 cases were reviewed. The mean gestation at delivery was 37.1 weeks. The median twin-to-twin delivery interval was 16.5 minutes. There were significant negative correlations between twin-to-twin delivery interval and both the umbilical cord arterial and venous pH and base excess of the second twin (P <0.05). There were also significant positive correlations between both arterial and venous partial pressure of CO2 and the delivery interval (P <0.05). Similar changes were found even if the analyses were limited to those who had normal vaginal deliveries. The umbilical arterial pH of Twin 2 was <7.00 in none of the cases delivered within 15 minutes of the birth of Twin 1, 5.9% if within 16-30 minutes, and 27% if more than 30 minutes. Among those with an inter-twin delivery interval of more than 30 minutes, 73% had cardiotocographic evidence of fetal distress which required operative delivery. CONCLUSIONS: Umbilical cord arterial and venous values of pH, partial pressure of CO2 and base excess of the second twin deteriorate with increasing twin-to-twin delivery interval. Risks of fetal distress and acidosis in the second twin are high when the twin-to-twin delivery interval is beyond 30 minutes. |
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Authors:
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Tak-Yeung Leung; Wing-Hung Tam; Tse-Ngong Leung; Ingrid Hung Lok; Tze-Kin Lau |
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Publication Detail:
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Type: Journal Article; Twin Study |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 109 ISSN: 1470-0328 ISO Abbreviation: BJOG Publication Date: 2002 Jan |
Date Detail:
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Created Date: 2002-02-14 Completed Date: 2002-03-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 63-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Gas Analysis Carbon Dioxide / blood Delivery, Obstetric / methods* Female Fetal Blood / chemistry* Humans Hydrogen-Ion Concentration Partial Pressure Pregnancy Pregnancy, Multiple / blood* Retrospective Studies Time Factors Twins Umbilical Arteries |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
| Comments/Corrections | |
Comment In:
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BJOG. 2002 Dec;109(12):1424-5
[PMID:
12504998
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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