Monoamniotic Twin Pregnancy

1986 ◽  
Vol 35 (1-2) ◽  
pp. 99-105 ◽  
Author(s):  
R.H. Lumme ◽  
S.V. Saarikoski
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress Syndrome ◽  
Twin Pregnancy ◽  
Causes Of Death ◽  
Distress Syndrome ◽  
Preterm Labour ◽  
Central Hospital ◽  
Common Causes ◽  
Umbilical Cords ◽  
Twin Pregnancies

AbstractThe course and outcome of 23 monoamniotic (MA) twin pregnancies, delivered in Tampere University Central Hospital during the years 1964-1984, were studied retrospectively and compared to 1056 diamniotic (DA) twin pregnancies. The frequency of MA twins was 2.1% of twin pregnancies. Polyhydramnion complicated the pregnancy in 26% of MA vs 6% of DA pregnancies. Two cases were defined as acute polyhydramnion. Preterm labour was stated in 70% of MA pregnancies and deliveries before the 34th week were 4 times more common in MA than DA pregnancies. The cesarean section rate was more than double in MA pregnancies (39%). Entanglement of the umbilical cords was noted four times, and prolapse of the cord in three vaginally delivered cases. Perinatal mortality was 28% in MA vs 5% in DA twins. The most common causes of death were respiratory distress syndrome, congenital malformation and feto-fetal transfusion.

Perinatal Deaths in Twin Pregnancy: A 22-Year Review

1988 ◽  
Vol 37 (1) ◽  
pp. 47-54 ◽  
Author(s):  
R.H. Lumme ◽  
S.V. Saarikoski
Keyword(s):  
Perinatal Mortality ◽  
Twin Pregnancy ◽  
Distress Syndrome ◽  
Preterm Births ◽  
Central Hospital ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Obstetric Management ◽  
Twin Pregnancies ◽  
Early Neonatal Deaths

AbstractChanges in the management of 1120 twin pregnancies delivered in Tampere University Central Hospital during the years 1964-1985 were studied, together with changes in the pattern of perinatal deaths. Perinatal mortality decreased from 7.4% in 1964-68 to 3.5% in 1981-85. There were no significant changes in stillbirths. The decrease of perinatal mortality resulted from a reduction in early neonatal deaths, mainly those due to respiratory distress syndrome. Changes in obstetric management include earlier diagnosis by ultrasound, intrapartum monitoring, and an increase in cesarean section rate from 4% to 32%. There is still a need for a reduction in the number of very early preterm births, and for more effective intrauterine supervision of twin pregnancies.

Incidence of Respiratory Distress Syndrome Following Antenatal Betamethasone: Role of Sex, Type of Delivery, and Prolonged Rupture of Membranes

PEDIATRICS ◽  
1981 ◽  
Vol 67 (5) ◽  
pp. 614-617 ◽  
Author(s):  
Apostolos N. Papageorgiou ◽  
Eleanor Colle ◽  
Evangelia Farri-Kostopoulos ◽  
Morrie M. Gelfand
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Sex Type ◽  
A Prospective Study ◽  
Age Range ◽  
Type Of Delivery ◽  
Proportional Reduction

Premature male infants have a higher incidence of respiratory distress syndrome (RDS) than female infants (male/female = 1.7:1.) With the demonstration that antenatal use of betamethasone significantly reduces the incidence of RDS, a proportional reduction or possibly a complete elimination of the discrepancy between the two sexes might be expected. The role that sex, type of delivery, and prolonged rupture of membranes (PROM) may play in the development of RDS was tested in a prospective study of RDS prevention with betamethasone. A full course of betamethasone, ie, 12 mg, 24 hours apart, was given antenatally to 94 infants of 27 to 34 weeks gestation. The incidence of RDS in male infants was 29.1% vs 8.6% in female infants (P < .02). The incidence of RDS among male babies delivered by cesarean section (30.3%) or vaginally (29.7%) was not statistically different, nor was there a difference between those with PROM > 24 hours (26.9%) and those without PROM (31.8%). The same was true of the incidence of RDS among female infants: cesarean section (14.2%) vs vaginal delivery (6.2%) and PROM > 24 hours (8%) vs (9.5%) without PROM. We conclude that: (1) Prevention of RDS with betamethasone is far more effective in female infants. The natural ratio of male/female of 1.7:1 becomes 3.4:1. (2) Once lung maturity has been achieved with betamethasone, the type of delivery plays no role in the development of RDS. (3) PROM does not add extra protection from RDS in the 27- to 34-week gestational age range.

OBSERVATIONS ON THE RELATIONSHIP BETWEEN DURATION OF RUPTURE OF THE MEMBRANES AND THE DEVELOPMENT OF IDIOPATHIC RESPIRATORY DISTRESS SYNDROME

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Jing Ja Yoon ◽  
Rita G. Harper
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Maternal Diabetes ◽  
Fetal Asphyxia ◽  
History Of ◽  
Idiopathic Respiratory Distress Syndrome ◽  
The Relationship

Retrospective analysis of 211 premature infants between 1,001 and 2,165 gm at birth revealed a decreased incidence of idiopathic respiratory distress syndrome in infants with rupture of the membranes more than 24 hours prior to delivery. Infants with factors which are known to predispose to idiopathic respiratory distress syndrome (maternal hemorrhage, maternal diabetes, fetal asphyxia, twin B, history of a sibling with idiopathic respiratory distress syndrome and cesarean section) were then eliminated. One hundred and twenty infants remained. Infants with rupture of the membranes more than 24 hours prior to delivery had a significantly lower incidence of idiopathic respiratory distress syndrome when compared with infants with rupture of the membranes less than 12 hours prior to delivery (P<0.05). From this study it appears that rupture of the membranes for more than 24 hours prior to delivery protects against the development of idiopathic respiratory distress syndrome.

scholarly journals Clinical Study on Different Delivery Methods of Twin Pregnancy

2021 ◽  
Author(s):  
Liyan Hu
Keyword(s):  
Cesarean Section ◽  
Pregnancy Outcome ◽  
Vaginal Delivery ◽  
Twin Pregnancy ◽  
Delivery Methods ◽  
Preterm Premature Rupture ◽  
Key Points ◽  
Baseline Information ◽  
The Difference ◽  
Twin Pregnancies

Objective To investigate the effect of different methods of delivery on the outcome of twin pregnancies. Methods This is a retrospective cohort review of 627 twin pregnancies with delivery from January 2016 to December 2019. According to the clinical guidelines for cesarean section, the cesarean section and vaginal delivery groups were determined. Finally, the baseline information, delivery method, pregnancy outcome, and maternal and infant complications of the two groups were compared. Results For different delivery methods, the incidence of preeclampsia was significantly higher in the cesarean section group than in the vaginal delivery group (χ2 = 4.405, p < 0.05). There were 23 fetal growth ratios (FGR) in the cesarean section group, which were significantly higher than the vaginal delivery group (χ2 = 4.740, p < 0.05). However, the incidence of preterm premature rupture of membranes (PPROM) in the vaginal delivery group was significantly higher than in the cesarean section group (χ2 = 5.235, p < 0.05). In addition, the volume of postpartum bleeding in the vaginal delivery group was significantly higher than in the cesarean section group (t = 4.723, p < 0.001). The neonatal weights and 5-minute Apgar scores of the vaginal delivery group were lower than the cesarean section group, and the difference was statistically significant. In the vaginal delivery group, 48 and 26 neonates were transferred to the intensive care and neonatal units, respectively, which were significantly higher than in the cesarean section group (χ2 = 5.001, p < 0.05). Conclusion The major complications of a twin pregnancy are gestational diabetes mellitus and PPROM. Cesarean section can reduce the rate of neonatal asphyxia in twins and improve the pregnancy outcome. Key Points

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