Neonatal Outcomes Of Twins Research Articles

Neonatal Outcomes of Twins and Triplets

Neonatal Outcomes of Twins and Triplets

Neonatal and maternal outcomes in twin gestations ≥32 weeks according to the planned mode of delivery

Objective To determine a possible relationship between neonatal and maternal outcomes in twin gestations and the planned mode of delivery. Study design A single-centre retrospective cohort study in twins ≥32 weeks of gestational age was performed. Baseline characteristics, and neonatal and maternal outcomes were documented according to the planned mode of delivery: a planned caesarean section or a planned vaginal birth. Statistical analysis was performed using chi-square test. Fisher exact test was used in case correction was needed. Results During the study period (1999–2002), 164 twins ≥32 weeks were enrolled in the study. In 29 women (17.7%) an elective caesarean section was performed. The remaining 135 twins (82.3%) were allowed to start a vaginal delivery. An emergency or an urgent secondary caesarean section for both twins was performed in 26 women, and in 2 women for twin B only. One twin B baby died during planned vaginal delivery. No significant differences in perinatal mortality and serious neonatal morbidity were found between both groups (10.3% versus 9.6%). Neonatal outcomes in twins A were significantly better than in twins B (2.4% versus 7.3%), independent of the planned mode of delivery. Serious maternal morbidity was not significantly different between both groups (13.8% versus 19.3%), although 2 women in the elective caesarean section group needed a relaparotomy for haemorrhage. Conclusion Our results do not support an elective caesarean section for twin gestations ≥32 weeks. The success rate of vaginal delivery in the planned vaginal birth group was nearly 80%.

Toward single embryo transfer policy

Toward single embryo transfer policy

The role of adjusted birthweight in adverse neonatal outcome in twins

The role of adjusted birthweight in adverse neonatal outcome in twins

Optimal threshold of intertwin weight difference for the prediction of adverse neonatal outcome in twins delivered at

Multiple gestations are at increased risk for prematurity, as well as perinatal mortality and morbidity. Several independent investigators have identified gestational age at delivery and birth weight discordance as the most important independent predictors of fetal mortality or neonatal morbidity among preterm twins. The goal of this study is to establish the optimal threshold of birth weight discordance for prediction of adverse outcome in preterm twins.

Periventricular leukomalacia and mode of delivery in twins under 1500 g

Background: The optimal mode of delivery in twin gestations remains undefined, particularly for twins weighing less than 1500 g. Objective: To evaluate the impact of the mode of delivery on neonatal outcome in twins below 1500 g. Materials and methods: In this multicenter cohort study during 1999, 66 sets of twins born in hospital and weighing below 1500 g formed our study group. Antenatal and neonatal parameters and their relationship to mode of delivery were studied, based on a factor analysis. Analysis of covariance was used to assess the effect of the mode of delivery on postnatal factors, with antenatal parameters used as covariates. Results: Statistical analysis showed that infants delivered vaginally had significantly more periventricular leukomalacia than those children delivered by Cesarean section (p = 0.03). The estimated odds for leukomalacia were higher in the vaginal than in the Cesarean group when adjusted for covariates (OR = 4.7; 95% CI = 1.0, 25.15). Conclusion: Routine Cesarean section should be recommended in twin gestations with infants weighing less than 1500 g, regardless of gestational age or fetal presentation.

Periventricular leukomalacia and mode of delivery in twins under 1500 g

Background: The optimal mode of delivery in twin gestations remains undefined, particularly for twins weighing less than 1500 g.Objective: To evaluate the impact of the mode of deliveryon neonatal outcome in twins below 1500 g.Materials and methods: In this multicenter cohort study during 1999, 66 sets of twins born in hospital and weighing below 1500 g formed our study group.Antenatal and neonatal parameters and their relationship to mode of delivery were studied, based on a factor analysis. Analysis of covariance was used to assess the effect of the mode of delivery on postnatalfactors, with antenatal parameters used as covariates.Results: Statistical analysis showed that infants delivered vaginally had significantly more periventricular leukomalacia than those childrendelivered by Cesarean section (p = 0.03). The estimated odds for leukomalacia were higher in the vaginal than in the Cesarean group when adjusted for covariates (OR = 4.7; 95% CI = 1.0, 25.15).Conclusion:Routine Cesarean section should be recommended in twin gestations with infants weighing less than 1500 g, regardless of gestational age or fetal presentation.

The cerebroplacental Doppler ratio and neonatal outcome in diamnionic monochorionic and dichorionic twins

Objective: Neonatal outcome in twins was studied in relation to the cerebroplacental ratio (CPR). Methods: Seventy-five infants from twin pregnancies with fetal Doppler data obtained within 3 weeks of delivery were candidates for study (23 infants from diamnionic monochorionic and 52 infants from diamnionic dichorionic twin pregnancies). Multivariate regression analyses were expanded to include 114 twin infants (34 diamnionic monochorionic and 80 diamnionic dichorionic twins). Patients with twin transfusion syndrome were excluded from analysis in the monochorionic group. Targeted ultrasound examination with biometry was performed, and Doppler resistance index (RI) of the umbilical artery (UA) and the middle cerebral artery (MCA) were obtained, and the CPR, a measure of blood flow redistribution, was calculated. Outcome variables included major complications, growth restriction, days of ventilator and oxygen use, days in the neonatal intensive care unit and length of stay. Results: The CPR was correlated more highly with adverse outcomes such as birth weight, special-care nursery days and length of stay than were the UA RI or the MCA RI. The CPR was significantly lower in monochorionic compared with dichorionic twins (1.12 vs. 1.27, p = 0.01). Multivariate regression analyses conducted separately on each twin group also demonstrated that CPR was superior to UA RI and MCA RI in predicting length of stay and restricted growth. Among the Doppler variables, the CPR showed the highest sensitivity for growth restriction (67%). Conclusion: In twins, CPR was superior to UA RI and MCA RI in predicting adverse neonatal events.

Effect of mode of delivery on neonatal outcome of twins with birthweight under 1500 g.

The purpose of this retrospective study was to evaluate. The mode of delivery on neonatal outcome of twins weighing <1500 g. We reviewed the effect of birth order, presentation, and method of delivery on neonatal outcome in twin gestation under 1500 g at Princess Badeea' Teaching Hospital in North Jordan over the 6-years from 1994 to 1999. During the study period, there were 51475 deliveries of which 695 were twin gestations. One hundred and eight (108) sets of twins weighing <1500 g were included in the study (15.5%), of which 41 were in vertex-vertex presentation, 40 in vertex-nonvertex, and 27 with first twin in nonvertex presentation. The second twin pregnancies characterized by a higher incidence of respiratory distress syndrome (82 vs. 70%; p=0.02) more neonatal mortality (23 vs. 17.6%), and lower Apgar score at 1 and 5 min. Cesarean delivery for vertex-vertex presentation did not improve the neonatal outcome. Rather, the incidence of RDS was significantly greater in this group delivered by cesarean section (65.6 vs. 42%, p=0.012). For nonvertex presentation, those delivered by cesarean section had a lower incidence of neonatal mortality. We concluded there was no advantage for cesarean delivery that could be demonstrated after multivariate analysis to correct the differences in birthweight between the groups. Therefore, the differences in the neonatal outcome of non vertex twins presentation accounted for the differences in birthweight, rather than in mode of delivery.

The effect of mode of delivery on neonatal outcome of twins with birthweight under 1500g

International Journal of Gynecology & ObstetricsVolume 70, Issue S4 p. D37-D37 The effect of mode of delivery on neonatal outcome of twins with birthweight under 1500g S.M. Ziadeh, S.M. ZiadehSearch for more papers by this authorE. Sunna, E. SunnaSearch for more papers by this authorL.F. Badria, L.F. BadriaSearch for more papers by this author S.M. Ziadeh, S.M. ZiadehSearch for more papers by this authorE. Sunna, E. SunnaSearch for more papers by this authorL.F. Badria, L.F. BadriaSearch for more papers by this author First published: 11 December 2003 https://doi.org/10.1016/S0020-7292(00)81770-1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume70, IssueS42000Pages D37-D37 RelatedInformation