Document Detail


[Management of dichorionic twin delivery at term with cephalic-presenting first twin - a monocentric retrospective cohort study].
MedLine Citation:
PMID:  21031330     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To assess neonatal outcome and delivery mode in dichorionic twin delivery at term with a cephalic-presenting first twin.
METHODS: A retrospective cohort study of 308 twin deliveries after 37 completed weeks of gestation with a cephalic-presenting first twin undertaken in one perinatal center with active management of second twin delivery. The neonatal outcome was measured by the Apgar score, the umbilical artery pH and the transfer into the neonatal unit.
RESULTS: In the whole group, 57% were vaginally delivered and 43% needed a Cesarean delivery. The planned vaginal delivery group contained 71% while the planned elective Cesarean delivery group contained 29%. In the planned vaginal delivery group 80% were delivered vaginally, in 15% an emergency Cesarean was necessary, 5% had a vaginal delivery of the first twin followed by Cesarean delivery of the second twin. The neonatal outcome of the second twin shows a higher risk. There are significant differences in the rates of the second twin having lower rates of the umbilical artery pH >7.20 in the group of planned vaginal delivery. The higher risks are compensated in the group of planned elective Cesarean delivery.
CONCLUSIONS: Planned vaginal delivery of dichorionic twins at term and active second-stage management is associated with lower rate of normal neonatal outcome. These risks should be considered in prenatal informed consent discussions with the pregnant woman.
Authors:
J W Dudenhausen; M Golic; R Kirschner; M Brauer
Publication Detail:
Type:  English Abstract; Journal Article     Date:  2010-10-28
Journal Detail:
Title:  Zeitschrift für Geburtshilfe und Neonatologie     Volume:  214     ISSN:  1439-1651     ISO Abbreviation:  Z Geburtshilfe Neonatol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508901     Medline TA:  Z Geburtshilfe Neonatol     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  205-9     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
Klinik für Geburtsmedizin, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin. Joachim.Dudenhausen@charite.de
Vernacular Title:
Geburtsleitung bei dichorialen Zwillingen am Termin bei vorangehendem Zwilling in Schädellage - eine monozentrische retrospektive Kohortenstudie.
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