scholarly journals Impact of intertwin interval on short‐term neonatal outcomes of the second twin in dichorionic pregnancies with vaginal delivery

2019 ◽  
Vol 145 (2) ◽  
pp. 193-198
Author(s):  
Marta Benito ◽  
Carlos De Bonrostro ◽  
Andrea Agustín ◽  
Montserrat Roca ◽  
Jose M. Campillos ◽  
...  
2020 ◽  
Vol 80 (10) ◽  
pp. 1033-1040
Author(s):  
Anne Dathan-Stumpf ◽  
Katharina Winkel ◽  
Holger Stepan

Abstract Objective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig. Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study. Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores. Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.


2006 ◽  
Vol 9 (5) ◽  
pp. 685-690 ◽  
Author(s):  
Read Salim ◽  
Michal Lavee ◽  
Zohar Nachum ◽  
Eliezer Shalev

AbstractThe 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.


2018 ◽  
Vol 218 (1) ◽  
pp. S71
Author(s):  
Thomas Schmitz ◽  
Diane Korb ◽  
Catherine Battie ◽  
Anne-Gael Cordier ◽  
Céline De Carné Carnavalet ◽  
...  

2020 ◽  
Author(s):  
Huiqian Zeng ◽  
Baohua Lin ◽  
Huizhu Zhang ◽  
Kaimin Guo ◽  
Ping He ◽  
...  

Abstract BackgroundThe effects of intrapartum fever associated with epidural analgesia in nulliparous women on the short-term maternal and neonatal outcomes are not well understood.Methods We included 2076 nulliparous women who received regular obstetric examination and gave birth at Guangzhou Women and Children’s Medical Center from January 1, 2020 to June 30, 2020. All cases were singleton full-term pregnancies, and all foetuses were in cephalic presentation. We allocated 817 women with temperature >38℃ during labour into the fever group and 1259 women with temperature ≤38℃ during labour to the non-fever group. The short-term maternal and neonatal outcomes in the two groups were compared. Results in the fever group, 8.3% of pregnant women converted to caesarean delivery. The conversion rate in the non-fever group was 5.2% (p = 0.004). The rates of mild neonatal asphyxia, severe neonatal asphyxia, and neonatal hospitalisation in the fever group were higher than those in the non-fever group (χ2 = 12.070, 6.325, and 6.821, respectively, all P<0.05). The 1194 pregnant women in the fever group who had vaginal deliveries spent 756.46 ± 256.43 minutes in the first stage of labour and 65.74 ± 47.63 minutes in the second stage, significantly longer than the 749 women who had vaginal deliveries in the non-fever group (P<0.001, P=0.001). The assisted delivery rate for vaginal delivery in the fever group was 49.0%, significantly higher than that in the non-fever group (2=49.738, P<0.001). The rates of mild neonatal asphyxia, severe neonatal asphyxia, neonatal acidosis, and neonatal hospitalisation with vaginal delivery in the fever group were higher than those in the non-fever group (2=15.375, 6.597, 22.265, and 7.322, respectively, and p<0.001, 0.010, <0.001, and 0.007, respectively).Conclusions Epidural analgesia-associated intrapartum fever in nulliparous women increased the rates of short-term adverse maternal and neonatal outcomes, indicating that efforts are needed to prevent incidence of intrapartum fever due to administration of epidural analgesia.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046616
Author(s):  
Rokuhiro Asahina ◽  
Hiroyuki Tsuda ◽  
Yuki Nishiko ◽  
Kazuya Fuma ◽  
Momoko Kuribayashi ◽  
...  

ObjectiveThis study aimed to evaluate the success rate of vaginal delivery, the reasons for unplanned caesarean delivery, the rate of umbilical cord prolapse and the risk of umbilical cord prolapse in twin deliveries.DesignRetrospective cohort study.SettingSingle institution.ParticipantsThis study included 455 women pregnant with twins (307 dichorionic and 148 monochorionic) who attempted vaginal delivery from January 2009 to August 2018. The following criteria were considered for vaginal delivery: diamniotic twins, cephalic presentation of the first twin, no history of uterine scar, no other indications for caesarean delivery, no major structural abnormality in either twin and no fetal aneuploidy.ResultsThe rate of vaginal delivery of both twins was 89.5% (407 of 455), caesarean delivery of both twins was 7.7% (35 of 455) and caesarean delivery of only the second twin was 2.9% (13 of 455). The major reasons for unplanned caesarean delivery were arrest of labour and non-reassuring fetal heart rate pattern. The rate of umbilical cord prolapse in the second twin was 1.8% (8 of 455). Multivariate analysis revealed that abnormal umbilical cord insertion in the second twin (velamentous or marginal) was the only significant factor for umbilical cord prolapse in the second twin (OR, 5.05, 95% CI 1.139 to 22.472, p=0.033).ConclusionsAbnormal umbilical cord insertion in the second twin (velamentous or marginal) was a significant factor for umbilical cord prolapse during delivery. Antenatal assessment of the second twin’s umbilical cord insertion using ultrasonography would be beneficial.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  

During the coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks postdischarge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6-40) and 3077.50 ± 697.64 gr (1720-3900), respectively. Apgar score of the first and fifth minutes in all neonates was ≥8 and ≥9 out of 10, respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP) in three infants are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results similar to those described for nonpregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.


2021 ◽  
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  

Abstract During the Coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks post-discharge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 who were admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6 − 40) and 3077.50 ± 697.64 gr (1720–3900) respectively. Apgar score of the first and fifth minutes in all neonates was ≥ 8 and ≥ 9 out of 10 respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP), in three infants, are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results almost similar to those described for non-pregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.


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