Abstract
Objective:To document the neonatal outcomes of preterm birth in twin pregnancies and to investigate whether perinatal and obstetric parameters are associated with clinical outcomes.Methods:This retrospective trial was conducted on data gathered from 176 preterm twins delivered in the obstetrics and gynecology department of our tertiary care center. Data extracted from medical files of 88 pregnant women who gave preterm birth (at 260/7 to 366/7 gestational weeks) to twins were analyzed. Maternal/fetal descriptive and obstetric parameters, sonographic data, route of delivery, indication for cesarean section, birth weight, Apgar scores, head circumference, umbilical cord length and placental weight were noted.Results:The average age of the pregnant women was 28.8±6.4 years and ultrasonographic gestational age was 31.9±2.6 weeks. Apgar scores at 1st minute were affected significantly by fetal body weight (p=0.001), gestational age (p=0.001), height (p=0.004) and head circumference (p=0.011). None of these variables exhibited a noteworthy effect on Apgar scores at 5th minute.Conclusion:Efforts must be made to achieve advancement of gestational age until delivery in the follow-up preterm of twins. A well-established algorithm with special emphasis to risk factors is necessary to standardize and popularize the appropriate management strategy.
Highlights
Table-I: Baseline descriptive maternal and perinatal data in our series of preterm twins
The objective of the present study was to outline the clinical outcomes in preterm births of twin pregnancies and to seek whether any perinatal, surgical and obstetric parameters are related with clinical
Table-III: Impacts of gestational weeks, height, head circumference, placental weight, length of umbilical cord, gender of the neonate and route of delivery on Apgar scores at 1st minute
Summary
Available data were insufficient to allow recommendations to be made about the ideal route of delivery.[1,7] There is debate on the risks of neonatal morbidity and mortality related to complications of vaginal delivery in preterm twin pregnancies. This is a major concern for second twins due to the higher probability of hypoxia after delivery maneuvers, cord prolapse or premature placental separation.[8,9] A recent Cochrane systematic review focusing on the best mode of delivery for preterm infants concluded that recruiting difficulties are likely to make a randomized study on this topic impossible.[10]. Our purpose was to document the neonatal outcomes of preterm birth in twin pregnancies and to investigate whether perinatal and obstetric parameters are associated with clinical outcomes
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