Evaluation of vaginal birth safety in twin pregnancies with the first twin in cephalic presentation

Objective: To evaluate vaginal birth safety by comparing the results of cesarean birth in twin pregnancies with the first twin in vertex presentation. Material and methods: A retrospective cohort study of vertex-presenting twin pregnancies between 32 weeks 0 days and 38 weeks 6 days of gestation was conducted at our hospital from January 2013 to December 2014. The study population was divided according to the mode of birth. The primary outcome was early neonatal mortality, and secondary outcomes related to maternal and perinatal clinical characteristics were analysed between the groups. Results: Of 45,166 births, 1.92% (n = 869) were twin pregnancies. Of the 295 pregnancies meeting the study criteria, 30.16% (n = 89) were in the vaginal birth group, while the remaining 69.84% (n = 206) were in the cesarean birth group. In the vaginal birth group, all the first twins were delivered via vaginal birth, while among the second twins, 82.03% (n = 73) were delivered via vaginal birth, and the remaining 17.97% (n = 16) were delivered via cesarean birth. In the vaginal birth group, the early neonatal mortality rate was 22.4‰ (n = 2), and it was 9.7‰ (n = 2) in the cesarean birth group. All of the deaths occurred in pregnancies under 37 weeks of gestation. Conclusion: The neonatal outcomes between the vaginal birth and cesarean birth groups were similar in term pregnancies with the first in twin vertex presentation, whereas adverse neonatal outcomes were increased in the vaginal birth group in preterm second twin pregnancies.

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Early neonatal mortality rate and the risk factors in Wangaya hospital

Paediatrica Indonesiana ◽

10.14238/pi48.5.2008.306-11 ◽

2016 ◽

Vol 48 (5) ◽

pp. 306

Author(s):

Made Lndah Nastiti Utami Budha ◽

Wayan Retayasa ◽

Made Kardana

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Mortality Rate ◽

Neonatal Mortality ◽

Gestational Age ◽

Neonatal Death ◽

Early Neonatal Death ◽

Neonatal Mortality Rate ◽

Early Neonatal Mortality ◽

Early Neonatal Mortality Rate

Background The first week of life of a neonate is a critical period.In Asia, early neonatal mortality rate remains high.Objective To investigate early neonatal mortality rate and the riskfactors in Wangaya Hospital.Methods A cross sectional study was carried out retrospectivelyon neonates registered at Perinatology Unit, Wangaya HospitalDenpasar, Bali since January 2006. The study was done fromOctober to November 2007. Data was obtained from medicalrecord, analyzed as univariate using chi-square test or Fisher'sexact test and multivariate logistic regression analysis model.Results Early neonatal mortality rate in Wangaya Hospital was 38.7per 1000 livebirths. Univariate analyses showed that there werefive significant risk factors of early neonatal death, i.e., respiratorydistress, asphyxia, birth weight less than 2500 grams, sepsis, andgestational age less than 3 7 weeks. Multivariate analysis showedthat those five variables were significant as risk factors of earlyneonatal death i.e., OR (95% confidence interval) for respiratorydistress: 16.8 (3.7 to 76.6)], asphyxia: 13.5 (6.1 to 29.9)], birthweight <2500 grams: 8.1 (3.3 to 19.9)], sepsis: 7.3 (3.1 to 17.1),and gestational age <37 weeks: 3.5 (1.6 to 7.8)].Conclusions Early neonatal mortality rate in Wangaya Hospitalremains high. Respiratory distress, asphyxia, birth weight <2500gram, sepsis, and gestational age <37 weeks were independent riskfactors of early neonatal death.

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Perinatal morbidity and early neonatal mortality in twin pregnancies

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2013.31017 ◽

2013 ◽

Vol 03 (01) ◽

pp. 78-89 ◽

Cited By ~ 9

Author(s):

Corinna Peter ◽

Paul Wenzlaff ◽

Jan Kruempelmann ◽

Gerhard Alzen ◽

Eva Bueltmann ◽

...

Keyword(s):

Neonatal Mortality ◽

Perinatal Morbidity ◽

Early Neonatal Mortality ◽

Twin Pregnancies

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Women’s Perceptions of Contributory Factors for Successful Vaginal Birth After Cesarean

International Journal of Childbirth ◽

10.1891/2156-5287.2.2.96 ◽

2012 ◽

Vol 2 (2) ◽

pp. 96-106 ◽

Cited By ~ 13

Author(s):

Brodie Godden ◽

Yvonne Hauck ◽

Tasmin Hardwick ◽

Sara Bayes

Keyword(s):

Vaginal Birth ◽

Vaginal Birth After Cesarean ◽

Policy Makers ◽

Cesarean Birth ◽

Contributory Factors ◽

Women’S Perceptions ◽

Mode Of Birth ◽

King Edward Memorial Hospital ◽

Qualitative Descriptive ◽

Previous Cesarean

BACKGROUND:In July 2008, a new midwife-led “Next Birth After Cesarean” (NBAC) service was launched at King Edward Memorial Hospital (KEMH) in Perth, Western Australia. Midwives from the NBAC service provide antenatal care, evidence-based information about birth choices, tailored birth preparation classes, and assistance with developing birth plans to pregnant women who have had a previous cesarean birth.OBJECTIVE:To determine the contributory factors that women who were cared for by the NBAC service and experienced a vaginal birth after cesarean (VBAC) perceived to be associated with achieving their desired mode of birth.METHODS:A qualitative descriptive approach was used for this study in which semistructured interviews were conducted with 13 participant women who have achieved a VBAC and were analyzed using a modified “constant comparison” technique.FINDINGS:Two key themes reflecting personal and professional factors comprising eight subthemes emerged from analysis of interview data.CONCLUSIONS:These findings offer a unique perspective on the phenomenon of achieving a VBAC and provide maternity care practitioners and policy makers around the world with valuable insights into how the care environment might be enhanced for women who would prefer a vaginal birth after their previous cesarean section.

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Obstetric and perinatal outcomes of dizygotic twin pregnancies resulting from in vitro fertilization versus spontaneous conception: a retrospective study

PeerJ ◽

10.7717/peerj.6638 ◽

2019 ◽

Vol 7 ◽

pp. e6638 ◽

Cited By ~ 1

Author(s):

Hua Chen ◽

Ying Wan ◽

Haitao Xi ◽

Weijue Su ◽

Jing Cheng ◽

...

Keyword(s):

In Vitro Fertilization ◽

Perinatal Care ◽

Perinatal Outcomes ◽

Neonatal Outcomes ◽

Dizygotic Twin ◽

Vitro Fertilization ◽

Adverse Neonatal Outcomes ◽

Potential Risks ◽

Twin Pregnancies

This study was designed to to assess perinatal and neonatal outcomes of dizygotic twin pregnancies conceived naturally or by in vitro fertilization (IVF). After strict selection, the study included 470 dizygotic twin pregnancies. There were 249 resulting from IVF treatments and 221 conceiving spontaneously. After adjusting maternal age and primiparity, the results showed that there were no significant differences between the two groups (P > 0.05) in terms of maternal antenatal complications and neonatal outcomes. In conclusion, our study does not reveal increased risks for pregnancy-related complications and adverse neonatal outcomes in dizygotic twin pregnancies following IVF treatments. With these fundamental data, this study could provide a reference for perinatal care and clinical assisted reproductive technology (ART) treatment and help to inform infertile parents about the potential risks of IVF treatments.

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263: Twin pregnancies with different gender are related with adverse neonatal outcomes in dichorionic twins kyung

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2007.10.277 ◽

2007 ◽

Vol 197 (6) ◽

pp. S84

Author(s):

Joon Oh ◽

Ji Hyun Kang ◽

Hyung-Su Lim ◽

Chan-Wook Park ◽

Joong Shin Park ◽

...

Keyword(s):

Neonatal Outcomes ◽

Adverse Neonatal Outcomes ◽

Twin Pregnancies

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Reduced fetal movements is twin pregnancies and the association with adverse neonatal outcomes

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2020.01.050 ◽

2020 ◽

Vol 246 ◽

pp. 165-168

Author(s):

Michal Levy ◽

Michal Kovo ◽

Yakira Izaik ◽

Emilie Ben-Ezry ◽

Noa Gonen ◽

...

Keyword(s):

Neonatal Outcomes ◽

Reduced Fetal Movements ◽

Fetal Movements ◽

Adverse Neonatal Outcomes ◽

Twin Pregnancies

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Influence of the wars in Croatia and Bosnia and Herzegovina on the incidence and outcome of singleton premature births in the Split University Hospital

Open Medicine ◽

10.2478/s11536-008-0026-x ◽

2008 ◽

Vol 3 (2) ◽

pp. 187-193 ◽

Cited By ~ 3

Author(s):

Ivana Pavlinac ◽

Ana Marin ◽

Maja Valić ◽

Jelena Marušić ◽

Damir Roje ◽

...

Keyword(s):

Mortality Rate ◽

Neonatal Mortality ◽

Preterm Delivery ◽

Bosnia And Herzegovina ◽

University Hospital ◽

Hospital Data ◽

Neonatal Mortality Rate ◽

Early Neonatal Mortality ◽

Gynecology And Obstetrics ◽

Early Neonatal Mortality Rate

AbstractTo investigate the influence of the wars in Croatia and Bosnia and Herzegovina on incidence and perinatal outcome of singleton preterm births at the Department of Gynecology and Obstetrics in the Split University Hospital. Data were collected by reviewing patients’ files at the Department of Gynecology and Obstetrics from three periods: the three years before the war (1988–1990), during the war (1992–1994), and after the war (1996–1998). A total of 2,358 patients’ files of singleton preterm delivery were analyzed. Singleton preterm delivery rate decreased during the war (5.02%) and post-war period (4.74%) compared to the pre-war period (6.19%). Stillbirth and early neonatal mortality rates of singleton premature babies significantly increased during the war to 226%, compared to 193% before the war and 134% after the war. Early neonatal mortality rate was 215% during the war, 209% in the pre-war period, and 156% after the war. Despite the continuous decrease in singleton preterm birth rate throughout the observed periods, the increase in stillbirth rate and early neonatal mortality rate during the war might have been caused by the war. This may be due to primary gynecological care being inadequate for many pregnant women.

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Birth Defects in Singleton versus Multiple ART Births in Japan (2004–2008)

Journal of Pregnancy ◽

10.1155/2011/285706 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Syuichi Ooki

Keyword(s):

Neonatal Mortality ◽

Birth Defects ◽

Reference Group ◽

Reproductive Technology ◽

Neonatal Mortality Rate ◽

Early Neonatal Mortality ◽

Number Of Children ◽

Early Neonatal Mortality Rate ◽

The Mean ◽

The Impact

The purpose of the present study was to evaluate the relative risk (RR) of multiple births for birth defects after assisted reproductive technology (ART) using Japanese nationwide data from 2004 to 2008 with singletons as the reference group. In multiples compared to singletons, the percentage of birth defects per pregnancy were significantly higher (RR = 1.88, 95% confidence interval (CI) 1.60–2.13), the percentage of birth defects per live birth was not significantly higher (RR = 0.90, 95% CI 0.78–1.05 or RR = 0.94, 95% CI 0.81–1.10), and the early neonatal mortality rate was significantly higher (RR = 2.68, 95% CI 1.52–4.70 or RR = 2.80, 95% CI 1.60–4.92). The early neonatal mortality per 10,000 live births was slightly higher in ART (5.09) than in the general population (3.86). We concluded that the impact of birth defects after ART would be larger in families with multiples compared to families with singletons, since the mean number of children would be larger in the former.

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Perinatal outcomes in Finnish twins: a retrospective study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2670-3 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Annu-Riikka Susanna Rissanen ◽

Riina Maria Jernman ◽

Mika Gissler ◽

Irmeli Katriina Nupponen ◽

Mika Erkki Nuutila

Keyword(s):

Regression Analysis ◽

Neonatal Mortality ◽

Perinatal Mortality ◽

Neonatal Intensive Care ◽

Perinatal Outcomes ◽

Study Data ◽

Early Neonatal Mortality ◽

Medical Birth Register ◽

Binomial Regression ◽

Twin Pregnancies

Abstract Background To establish the changes in perinatal morbidity and mortality in twin pregnancies in Finland, a retrospective register research was conducted. Our extensive data from a 28-year study period provide important information on the outcome of twin pregnancies in Finland that has previously not been reported to this extent. Methods All 23,498 twin pregnancies with 46,996 children born in Finland during 1987–2014 were included in the study. Data were gathered from the Medical Birth Register and the Hospital Discharge Register (Finnish Institute for Health and Welfare, Finland) regarding perinatal mortality (PNM) and morbidity. For statistical analysis, binomial regression analysis and crosstabs were performed. The results are expressed in means, percentages and ranges with comparison to singletons when appropriate. Odds ratios from binomial regression analysis are reported. A p-value <0.05 was considered statistically significant. Results There were 46,363 liveborn and 633 stillborn twins in Finland during 1987–2014. Perinatal mortality decreased markedly, from 45.1 to 6.5 per 1000 for twin A and from 54.1 to 11.9 per 1000 for twin B during the study period. Yet, the PNM difference between twin A and B remained. Early neonatal mortality did not differ between twins, but has decreased in both. Asphyxia, respiratory distress syndrome, need for antibiotics and Neonatal Intensive Care Unit (NICU) stay were markedly more common in twin B. Conclusions In Finland, PNM and early neonatal mortality in twins decreased significantly during 1987–2014 and are nowadays very low. However, twin B still faces more complications. The outline provided may be used to further improve the monitoring and thus perinatal outcome of twins, especially twin B.

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