Twin births: cesarean section or vaginal delivery?
| Autor: | Anna Oldenburg, Line Rode, Steen Rasmussen, Lillian Skibsted, Elise Hoffmann, Ann Tabor |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Risk medicine.medical_specialty Population Cohort Studies Pregnancy Intensive care Infant Mortality Odds Ratio Twins Dizygotic medicine Humans education Twin Pregnancy Retrospective Studies Gynecology education.field_of_study Cesarean Section business.industry Vaginal delivery Infant Newborn Parturition Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study Twins Monozygotic General Medicine Odds ratio Delivery Obstetric medicine.disease Multivariate Analysis Apgar Score Intensive Care Neonatal Pregnancy Twin Female Apgar score business |
| Zdroj: | Acta Obstetricia et Gynecologica Scandinavica. 91:463-469 |
| ISSN: | 1600-0412 0001-6349 |
| DOI: | 10.1111/j.1600-0412.2011.01356.x |
| Popis: | Objective To assess morbidity and mortality in twin pregnancy deliveries, according to chorionicity and mode of delivery. Design Population-based retrospective cohort. Setting Fourteen obstetric departments in Denmark. Population One thousand one hundred and seventy-five twin pregnancies with two live fetuses at 36(+0) weeks of gestation. Methods Pregnancy outcomes assessed according to chorionicity and mode of delivery. Main outcome measures Poor outcome defined as five min Apgar score ≤ 7, umbilical artery pH Results Dichorionic (DC) twins, delivered after 36 gestational weeks, with intended vaginal delivery (n= 689) compared with DC twins with planned cesarean section (n= 371) had an increased risk of poor outcome [odds ratio (OR) 1.47, p= 0.037] after adjustment for body mass index, parity and weight discordance. There was no increased risk for poor outcome in monochorionic (MC) twins with intended vaginal delivery (n= 63) compared with planned cesarean section (n= 52; OR 0.87, 95% confidence interval 0.26-2.96). Nulliparity increased the risk of poor outcome in DC (OR 1.5, p= 0.03) and in MC twins (OR 4.01, p= 0.02), as well as birthweight discordance >300 g (DC, OR 1.50, p= 0.02; and MC, OR 6.02, p= 0.002). For DC twins, we found a significantly higher risk of poor outcome of the second-born twin compared with the first (OR 1.64, p= 0.001). Conclusions Dichorionic twins born after 36 weeks of gestation had a higher risk of poor outcome by intended vaginal delivery than by planned cesarean section. For MC twins, statistical differences in outcome by mode of delivery could not be seen. |
| Databáze: | OpenAIRE |
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