Document Detail

Effect of twin-to-twin delivery interval on umbilical cord blood gas in the second twins.
MedLine Citation:
PMID:  11843376     Owner:  NLM     Status:  MEDLINE    
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.
Tak-Yeung Leung; Wing-Hung Tam; Tse-Ngong Leung; Ingrid Hung Lok; Tze-Kin Lau
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Publication Detail:
Type:  Journal Article; Twin Study    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  109     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-02-14     Completed Date:  2002-03-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  63-7     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
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MeSH Terms
Blood Gas Analysis
Carbon Dioxide / blood
Delivery, Obstetric / methods*
Fetal Blood / chemistry*
Hydrogen-Ion Concentration
Partial Pressure
Pregnancy, Multiple / blood*
Retrospective Studies
Time Factors
Umbilical Arteries
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comment In:
BJOG. 2002 Dec;109(12):1424-5   [PMID:  12504998 ]

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

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