Cesarean delivery of the second twin after vaginal delivery of the first twin

1986 ◽  
Vol 154 (4) ◽  
pp. 936-939 ◽  
Author(s):  
Pawan K. Rattan ◽  
Robert A. Knuppel ◽  
William F. O'Brien ◽  
Jose C. Scerbo
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Second Twin

Occurrence and Predictors of Cesarean Delivery for the Second Twin After Vaginal Delivery of the First Twin

2004 ◽  
Vol 103 (3) ◽  
pp. 413-419 ◽  
Author(s):  
Shi Wu Wen ◽  
Karen Fung Kee Fung ◽  
Lawrence Oppenheimer ◽  
Kitaw Demissie ◽  
Qiuying Yang ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Second Twin

scholarly journals Evaluation of the risk of umbilical cord prolapse in the second twin during vaginal delivery: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046616
Author(s):  
Rokuhiro Asahina ◽  
Hiroyuki Tsuda ◽  
Yuki Nishiko ◽  
Kazuya Fuma ◽  
Momoko Kuribayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Cord Prolapse ◽  
Umbilical Cord Insertion ◽  
Umbilical Cord Prolapse ◽  
Second Twin

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.

Influences of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study

2018 ◽  
Vol 34 (3) ◽  
pp. 526-534 ◽  
Author(s):  
Cheng Chen ◽  
Yan Yan ◽  
Xiao Gao ◽  
Shiting Xiang ◽  
Qiong He ◽  
...  
Keyword(s):  
Cohort Study ◽  
Regression Model ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Exclusive Breastfeeding ◽  
Prospective Cohort ◽  
Breastfeeding Duration ◽  
Breastfeeding Initiation ◽  
Breastfeeding Practices

Background: Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. Methods: This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother–infant pairs in three communities in Hunan, China. Data about participants’ characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant’s birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. Results: The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p < .05). In addition, cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Conclusion: Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

Vaginal delivery of the second twin in unengaged cephalic presentation

2019 ◽  
Vol 34 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Birgit Arabin ◽  
Ioannis Kyvernitakis ◽  
Amr Hamza ◽  
Hoilger Maul ◽  
Mariarosaria Di Tommaso ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Second Twin

scholarly journals Delivery of Twin Gestation (≥ 32.0 Weeks): The Vaginal Route as a Practicable and Safe Alternative to Cesarean Section

2020 ◽  
Vol 80 (10) ◽  
pp. 1033-1040
Author(s):  
Anne Dathan-Stumpf ◽  
Katharina Winkel ◽  
Holger Stepan
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
Delivery Mode ◽  
Safe Alternative ◽  
Vaginal Deliveries ◽  
Twin Pregnancies ◽  
Second Twin

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.

scholarly journals Retrospective evaluation of attempted vaginal deliveries in dichorionic twin pregnancies

2020 ◽  
Author(s):  
Sabine Enengl ◽  
Peter Oppelt ◽  
Simon-Hermann Enzelsberger ◽  
Philip Sebastian Trautner ◽  
Omar Shebl ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Time Interval ◽  
Apgar Scores ◽  
Outcome Parameters ◽  
Retrospective Data Analysis ◽  
Vaginal Deliveries ◽  
Mode Of Birth ◽  
Twin Pregnancies ◽  
Second Twin

Abstract Purpose Numbers of planned cesarean deliveries are increasing in twin pregnancies, despite the lack of evidence for this approach, and the second twin is thought to be at risk for a poorer outcome. The aim of this study was to examine whether twins have a poorer outcome if an attempted vaginal delivery is changed to a cesarean section or combined delivery. Methods This retrospective data analysis included all women with dichorionic twin pregnancies attempting vaginal delivery over a 10-year period. Outcome parameters for the first and second twins relative to their mode of birth were compared. A correlation model between the interdelivery time interval and Apgar scores was calculated. Subgroup analyses assessing the birth mode of the first and second twins were conducted. Results A total of 248 women were enrolled in the study. The second twins had significantly lower values for outcome parameters, such as umbilical artery cord pH and Apgar scores in comparison with the first twins (P < 0.01). The subgroup analysis of birth modes in first and second twins showed a significantly poorer outcome in the cesarean section and combined delivery group (P < 0.05). The interdelivery time interval was significantly longer in the second twin cesarean section group (P < 0.01). There was no significant correlation between the interdelivery time intervals and Apgar scores (P > 0.05). Conclusion Although outcome parameters were significantly lower in second twins and twins born via secondary cesarean section, the clinical relevance of this appears to be negligible.

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