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

Pregnancy Outcome Among Twins Conceived After Subfertility Treatment Compared With Natural Twins: A Population-Based Study

2006 ◽  
Vol 9 (2) ◽  
pp. 279-284 ◽  
Author(s):  
Michael F. G. Murphy ◽  
Rachel E. Neale ◽  
Kate Hey ◽  
Valerie A. Seagroatt ◽  
Michael J. Goldacre ◽  
...  
Keyword(s):  
Social Class ◽  
Cesarean Section ◽  
Pregnancy Outcome ◽  
Ovulation Induction ◽  
Population Based ◽  
Population Based Study ◽  
Twin Birth ◽  
Twin Pregnancies

AbstractPregnancy outcome and characteristics of women who conceive following subfertility treatment remains a subject of great interest. We analyzed these variables among 199 women who delivered a registerable twin birth compared with 1773 women who delivered a naturally conceived twin birth in a population-based obstetric cohort drawn from around Oxford, England. Treatment was restricted to conceptions involving simple ovulation induction only. Treated mothers were of significantly higher social class and older, more likely to deliver girls and to be delivered by cesarean section, and significantly less likely to be smokers at the time of antenatal booking and to have delivered previous pregnancies. Pregnancy outcome was similar between the two groups for most measures, with the exception of birthweight which was lower in treated twins, though not significantly so. Overall the results are reassuring with respect to outcome in twin pregnancies following simple ovulation induction.

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.

scholarly journals Twin Pregnancies Labour Modus and Timing

2021 ◽  
Author(s):  
Panagiotis Tsikouras ◽  
Anna Chalkidou ◽  
Anastasia Bothou ◽  
Angeliki Gerede ◽  
Xanthoula Anthoulaki ◽  
...  
Keyword(s):  
High Risk ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Monozygotic Twins ◽  
Morbidity And Mortality ◽  
Assessment And Evaluation ◽  
Dizygotic Twins ◽  
The Impact ◽  
Twin Pregnancies

Twin pregnancies are categorized according to three factors, zygosity, chorionicity and amnionicity. Dizygotic twins are always dichorionic and diamniotic, where each twin has its own chorionic and amniotic sac. Monozygotic twins account for 1/3 of twin pregnancies and show higher morbidity and mortality. In monozygotic twins, chorionicity and amnionicity are determined by the time of zygote division. Chorionicity and amnionicity determine the risks of twin pregnancy. Morbitidies are shown notable decreasing tendency depending on improving of high risk obstetric and neonatal care, however is still discussed the optimum labour management in twin pregnancies Vaginal delivery in twin pregnancies is possible when both have cephalic presentation and in the late weeks of pregnancy during which the risks of prematurity are minimized. The aim of this review was the assessment and evaluation the impact of the labour modus and timing of termination of twin pregnancies due to rise of their occurrence based on scientific aspects of the new published literature on perinatal outcome.

scholarly journals Comparative Study on Fetomaternal Outcome after Lower Uterine Segment Caesarean Section and Vaginal Delivery in Eclamptic Patient

2020 ◽  
Vol 15 (1) ◽  
pp. 16-20
Author(s):  
Monika Khandoker ◽  
Swapna Biswas Joy ◽  
Sanjoy Kumar Das ◽  
Ananta Kumar Biswas
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Lower Uterine Segment ◽  
Electrolyte Imbalance ◽  
College Hospital ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Difference

Eclampsia has a high prevalence in our country with a high mortality rate. Eclampsia is uniquely a disease of pregnancy and regardless of gestational age. It is recognized that termination of pregnancy is the only definitive care of pathophysiological event in eclampsia. This study was done to observe fetomaternal outcome in Lower Uterine Segment Caesarean Section (LUCS) and vaginal delivery in eclamptic patient. This cross sectional analytical study was carried out in eclampsia department of Obst and Gyane in Dhaka Medical College Hospital from July 2016 to June 2018. A uniform protocol was followed in all cases to have appropriate history, physical findings and laboratory investigations. In this study 98.0% patients were conscious on admission in group I and 96.0% in group II. This study showed significant difference in recurrence of convulsion after delivery between two groups. Recurrence of convulsion was 30% in vaginal delivery group and 6% in the cesarean section group. Total complications were found in 46.0% and 16.0% patients in group I and group II respectively in this study. The difference was statistically significant (p<0.05) between two groups. In this study PPH was the most common complication in both the groups. Abruptio placenta was found more common among the vaginal delivery group. On the other hand, electrolyte imbalance was found more in cesarean section group. Maternal death was only 2% and 1% in group I and group II respectively. In this study live birth was found 64.0% and 79% in group I and group II respectively. Asphyxia was more in neonates in group I than group II which was statistically significant. Referral of asphyxiated babies to NICU was found 63.0% and 56.0% in group I and II respectively. The difference was statistically not significant between two groups. Faridpur Med. Coll. J. Jan 2020;15(1): 16-20

scholarly journals Influence of chorionicity on healthy twin pregnancy outcome

2020 ◽  
Vol 77 (10) ◽  
pp. 1080-1085
Author(s):  
Slavica Aksam ◽  
Snezana Plesinac ◽  
Jelena Dotlic ◽  
Dusica Kocijancic-Belovic ◽  
Mirjana Marjanovic-Cvjeticanin
Keyword(s):  
Pregnancy Outcome ◽  
Apgar Score ◽  
Twin Pregnancy ◽  
First Trimester ◽  
Monochorionic Twins ◽  
Membrane Rupture ◽  
Clinical Center ◽  
Gestational Week ◽  
Adverse Pregnancy ◽  
Twin Pregnancies

Background/Aim. It is still under debate in what sense and extent can chorionicity impact the pregnancy outcome of twins without gestational complications specific for monochorionicity. The study aimed to evaluate the effect of chorionicity on healthy twin pregnancy outcome. Methods. The study included patients with uncomplicated twin pregnancies after first trimester that were checked-up and delivered at the Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade during three years (2010?2013). Data regarding mother?s age, comorbidities, parity, presence and type of gestational complications, chorionicity, mode and time of pregnancy ending, birth-weight and Apgar score of twins were determined. Obtained data were compared and statistically analyzed. Results. The study included 361 women with mean age of 33 years. Regardless of chorionicity, twins were mostly born during the 36th gestational week and received Apgar score ? 8. Only three monochorionic twins were stillborn, two preterm (29 and 32 gestational week) and one in term (35 gestational week) delivery. Contrary, no intrauterine fetal deaths were recorded. Monochorionicity negatively correlated with having live-born twins (OR = 0.023; CI = [0.001?0.609]; p = 0.024), but was not associated with twins condition at birth, i.e. Apgar score (p = 0.345), pregnancy ending time (p = 0.578) or any other twins characteristic. However, premature preterm membrane rupture and earlier gestational week of pregnancy ending were important confounding factors for relationship between chorionicity and pregnancy outcome. Conclusion. Monochorionicity increases risk for adverse pregnancy outcomes even for uncomplicated, healthy twin pregnancy, but has no influence on the condition of twins who survive until term. If appropriate surveillance and therapy are applied, both healthy twins can be delivered at term regardless of chorionicity.

scholarly journals Pregnancy outcome during the bombing of Yugoslavia from Mart 24 to June 9, 1999

2006 ◽  
Vol 63 (4) ◽  
pp. 377-382 ◽  
Author(s):  
Dragan Krstic ◽  
Darko Marinkovic ◽  
Ljiljana Mirkovic ◽  
Jelena Krstic
Keyword(s):  
Cesarean Section ◽  
Pregnancy Outcome ◽  
Vaginal Delivery ◽  
Spontaneous Abortion ◽  
Perinatal Outcome ◽  
Lower Percentage ◽  
Previous Cesarean Section ◽  
Term Delivery ◽  
Duration Of Pregnancy ◽  
Previous Cesarean

Background/Aim. The aim of this study was to evaluate pregnancy outcome during the bombing of Yugoslavia in the period from March 24 to June 9, 1999. Methods. A retrospective study included a total of 81spontaneous abortion following XII gestation week, and 1448 deliveries, hospitalized in the regional hospital. The analyzed were: the incidence of spontaneous abortion, Cesarean section, post-term delivery, vaginal delivery following the previous Cesarean section within the period from March 24 to June 9, 1999, and compared to the same periods in 1998 and 2000 by the use of ?? and Kolgomorov-Smirnov tests. Results. Under the conditions of a three-month stress imposed by the bombing, significantly increased were the incidence of spontaneous abortion and vaginal delivery following the previous Cesarean section, while the incidence of Cesarean section and post-term delivery were decreased, but the incidence of perinatal outcome was paradoxically improved. The analysis of findings on admittance revealed that iterative Cesarean section was performed electively, close to the expected term of delivery, and vaginal delivery following the previous Cesarean section mainly two weeks before that term with the admittance finding confirming a high active stage pregnancy. Conclusions. Within the bombing, statistically significantly was increased the percentage of abortions after XII gestation week, and the biological duration of pregnancy was reduced. The reduced duration of pregnancy complete with the accelerated fetal mutation (also caused by the stress) resulted in better perinatal outcome, and statistically significantly lower percentage of Cesarean section.

scholarly journals Primary cesarean section in multigravidae: a case control study

2017 ◽  
Vol 6 (7) ◽  
pp. 2948
Author(s):  
Madhva Prasad S. ◽  
Anahita R. Chauhan
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
P Value ◽  
Previous Pregnancy ◽  
Admission Rates ◽  
Vaginal Deliveries ◽  
The Difference ◽  
Nicu Admission ◽  
One Year ◽  
Control Study

Background: Primary Cesarean Section (CS) is defined as CS in a patient who has not had a prior CS. While primigravidae contribute to the bulk of those undergoing primary CS, multigravidae (with only prior vaginal delivery) can also contribute. The purpose of this article is to examine the contribution of the group of multigravidae (with only prior vaginal delivery) and how they differ from primigravidae.Methods: A review of records was conducted for one year period. The confinements which were first or second para (which had undergone CS in either index pregnancy or previous pregnancy) were divided into primipara: primary CS and second para: primary CS. Various parameters were compared between the primipara undergoing primary CS and multipara undergoing primary CS.Results: Out of 1154 births, the number of CS was 401. Primary CS in primiparas was 266 (66.3%) and primary CS in multipara (with only prior vaginal deliveries) was 61(15.2%). Booking status, baby weights and NICU admission rates did not different significantly. Preterm deliveries, higher number of prior abortions; malpresentations, deep transverse arrest, antepartum hemorrhage was more common among the multipara group and the difference was statistically significant (p value < 0.05).Conclusions: Multipara (with prior vaginal delivery only) definitely contribute to primary CS rate and cannot be neglected. The profile of patients and the indications of CS in multipara appear to differ from those in primipara.

Analysis on the Outcome of Tubal Interstitial Pregnancy after Partial Cornual Resection

2021 ◽  
Vol 7 (5) ◽  
pp. 1865-1877
Author(s):  
Ye Wang ◽  
Beilei Ge
Keyword(s):  
Birth Weight ◽  
Cesarean Section ◽  
Pregnancy Outcome ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Uterine Horn ◽  
Delivery Time ◽  
Operation Condition ◽  
Interstitial Pregnancy ◽  
Rupture Of Uterus

Objective: To investigate the safety of re-pregnancy after partial cornual resection for tubal interstitial pregnancy. Methods: The clinical data of 22 cases of re-pregnancy after partial cornual resection from November 20J 3 to June 20J 9 were retrospectively analyzed, the operation condition, re-pregnancy outcome and neonatal outcome were analyzed. Results: 18 of the 21 cases were tubal interstitial pregnancy, the re-pregnancy interval was 6-36 months, the median delivery time was 17.4 moths, the median delivery time was 36 weeks (28-41+2W), there was 2 cases of birth weight <2500 g. The remaining 4 cases were interstitial heterotopic pregnancy, the median delivery time was 36 weeks (32+4-38+2W), there was 1 case of birth weight <2500g. Of the 22 patients, 21 were delivered by cesarean section and 1 was vaginal delivery, all the newborns survived. There were no cases of rupture of uterus, adhesion or implantation of placenta at uterine horn. Conclusion: The patients with tubal interstitial pregnancy after standard partial cornual resection have a good outcome of re-pregnancy.

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.

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