Document Detail


Outcome of twins delivery; predictors for successful vaginal delivery: a single center experience.
MedLine Citation:
PMID:  17032551     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to compare maternal and neonatal outcome of twin births according to mode of delivery and to isolate the factors predicting a successful vaginal delivery and those predicting a failed trial of labor (TOL) leading to an emergent cesarean section. We reviewed all twin deliveries during the years 1995 to 2004. Parameters studied include maternal age, parity, gestational age, maternal antepartum complications and postpartum complications, fetal presentations, birthweight, mode of delivery of each twin, Apgar scores and cord pH. During the study period there were 40,710 deliveries of which 804 (1.9%) were twin deliveries. Of the 804 twins, 398 (49.5%) had planned cesarean sections (PCS) and 406 (50.5%) entered a TOL. Maternal age and parity were similar among the groups. Neonatal outcomes and postpartum complications did not differ between the groups. Of 406 women who had a TOL, 84.9% eventually delivered both twins vaginally. A significantly higher percentage of antepartum complications were noted among those who failed the TOL compared to those with successful TOL (8.2% vs. 1.7%, p = .01). The number of neonates with pH of less than 7.0 did not differ between the groups although more neonates (2.5% vs. 0.4%, p = .05) among the failed TOL had an Apgar score of less than 7.0 at 5 minutes compared to successful TOL. Vaginal delivery of both twins after TOL occurred in 91% of vertex/vertex compared with 71.8% of vertex/nonvertex presenting twins (p < .01). Neonatal outcomes did not differ between both groups. Our results indicate that both vaginal and PCS are comparable options for vertex presenting first twin regardless of second twin presentation.
Authors:
Raed Salim; Michal Lavee; Zohar Nachum; Eliezer Shalev
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Twin research and human genetics : the official journal of the International Society for Twin Studies     Volume:  9     ISSN:  1832-4274     ISO Abbreviation:  -     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-11     Completed Date:  2007-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244624     Medline TA:  Twin Res Hum Genet     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  685-90     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Ha'Emek Medical Center, Afula, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / mortality
Delivery, Obstetric*
Female
Humans
Infant, Newborn
Labor Presentation
Labor, Obstetric
Outcome Assessment (Health Care)*
Pregnancy
Pregnancy Outcome
Pregnancy, Multiple*
Retrospective Studies
Trial of Labor
Twins*

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


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