Manejo del parto del segundo gemelo

Abstract

ObjectivesTo evaluate perinatal results in a retrospective analysis of the management of second twin delivery after first twin vaginal birth, among all M.A. Barber twin vaginal deliveries at the Obstetrics and Gynecology Unit of the University Maternity Hospital of Las Palmas from January 1, 1998 to December 31, 2002. Material and methodsOf 37,803 deliveries, 455 twin deliveries that took place during the study period were analyzed. All twin vaginal deliveries were retrospectively analyzed. Triplet gestations and twin births by cesarean section were excluded. The following variables were also analyzed: total number of twin deliveries, total number of live births, twin vaginal deliveries, maternal age, parity, gestational age, type of delivery and type of delivery of the second twin. Weight, sex, Apgar score, neonatal arterial pH lower than 7.10, admission to the neonatal intensive care unit (NICU), and mortality were also determined. ResultsThere were 454 twin deliveries during the study period with 902 live newborns. There were 262 vaginal twin deliveries. Maternal age was between 17 and 34 years in 77.9% of the parturient women. One hundred thirty-five women were primigravidas (51.5%). Gestational age at delivery was less 37 weeks in 39.3%. Regarding the management of second twin delivery, delivery was normal in 134 (51.1%), internal podalic version was performed in 60 (22.9%), vaginal breech delivery was performed in 41 (15.6%) and forceps delivery was carried out in 27 (10.3%). One hundred thirtythree newborns were male. One hundred forty-one newborns weighed less than 2,500 g (54.6%). Perinatal results were good. Apgar score at 5 minutes was more than 7 in 96.4% of the twins, pH was greater than 7.10 in 79.07%, and admission to the NICU was required in 26.7%.