OBJECTIVES: To study modes of delivery and neonatal morbidity of twins as a function of their presentation. STUDY DESIGN: The study related to 614 consecutive patients who gave birth to twins in the maternity ward of the Hôpital Robert Debré from 1992 to 2000. Group A (n=529) included patients who gave birth after 33 weeks of gestation and group B (n=85) before 33 weeks. The parameters studied were the mode of delivery, the need for intubation at birth, 5-min Apgar score <9, transfer to intensive care, death in the neonatal period. The chi-square test was used for statistical analysis. RESULTS: In group A, significantly more cesarean sections were performed for breech-breech (22.6%) and breech-vertex (16%) presentations than for vertex-vertex (10.3%) and vertex-breech (4.6%) presentations. In group B, there was no significant difference in the rate of vaginal delivery. Second vertex twins of group A had significantly higher frequencies of intubation (3%) at birth and transfer to intensive care (3%) than the vertex first twins born by vaginal delivery (p=0.01). These percentages were not significantly different from those observed for the second twins born by planned Cesarean section before the start of labor (2.8 and 5.6%, respectively). In group B, neonatal parameters did not differ significantly with the type of presentation at delivery. CONCLUSIONS: The type of presentation should not influence the choice of mode of delivery of twin pregnancies, whatever the gestational age.
OBJECTIVES: To study modes of delivery and neonatal morbidity of twins as a function of their presentation. STUDY DESIGN: The study related to 614 consecutive patients who gave birth to twins in the maternity ward of the Hôpital Robert Debré from 1992 to 2000. Group A (n=529) included patients who gave birth after 33 weeks of gestation and group B (n=85) before 33 weeks. The parameters studied were the mode of delivery, the need for intubation at birth, 5-min Apgar score <9, transfer to intensive care, death in the neonatal period. The chi-square test was used for statistical analysis. RESULTS: In group A, significantly more cesarean sections were performed for breech-breech (22.6%) and breech-vertex (16%) presentations than for vertex-vertex (10.3%) and vertex-breech (4.6%) presentations. In group B, there was no significant difference in the rate of vaginal delivery. Second vertex twins of group A had significantly higher frequencies of intubation (3%) at birth and transfer to intensive care (3%) than the vertex first twins born by vaginal delivery (p=0.01). These percentages were not significantly different from those observed for the second twins born by planned Cesarean section before the start of labor (2.8 and 5.6%, respectively). In group B, neonatal parameters did not differ significantly with the type of presentation at delivery. CONCLUSIONS: The type of presentation should not influence the choice of mode of delivery of twin pregnancies, whatever the gestational age.
Authors: Charlotte N Steins Bisschop; Tatjana E Vogelvang; Anne M May; Nico W E Schuitemaker Journal: Arch Gynecol Obstet Date: 2012-04-01 Impact factor: 2.344