Impact of mode of delivery after 32 weeks' gestation on neonatal outcome in dichorionic diamniotic twins

Soong, Stephen, Greer, Ristan M., Gardener, Glenn, Flenady, Vicki and Kumar, Sailesh (2015) Impact of mode of delivery after 32 weeks' gestation on neonatal outcome in dichorionic diamniotic twins. Journal of Obstetrics and Gynaecology Research, 42 4: 392-398. doi:10.1111/jog.12918


Author Soong, Stephen
Greer, Ristan M.
Gardener, Glenn
Flenady, Vicki
Kumar, Sailesh
Title Impact of mode of delivery after 32 weeks' gestation on neonatal outcome in dichorionic diamniotic twins
Journal name Journal of Obstetrics and Gynaecology Research   Check publisher's open access policy
ISSN 1447-0756
1341-8076
Publication date 2015-12-29
Year available 2015
Sub-type Article (original research)
DOI 10.1111/jog.12918
Open Access Status Not yet assessed
Volume 42
Issue 4
Start page 392
End page 398
Total pages 7
Place of publication Richmond, Victoria, Australia
Publisher Wiley-Blackwell Publishing
Collection year 2016
Language eng
Formatted abstract
Aim: The purpose of this study was to investigate neonatal outcome of dichorionic diamniotic twins born beyond 32 weeks’ gestation according to mode of delivery at a major tertiary center in Australia.

Methods: 
This was a retrospective cohort study of women with dichorionic diamniotic twins delivering at ≥32 weeks’ gestation at a large tertiary maternity center in Australia using data from a maternity database. Primary and secondary outcomes included mode of delivery, birthweight, stillbirth, Apgar score, neonatal unit admission, neonatal resuscitation, death and respiratory distress.

Results: 
Of 1261 women, 82.9% (1045/1261; 2090 babies) delivered at ≥32 weeks’ gestation. The mode of delivery for these babies was as follows: normal vaginal delivery, 419 (20%); instrumental delivery, 179 (8.6%); emergency cesarean section, 658 (31.5%); and elective cesarean section, 834 (39.9%). Babies delivered by emergency cesarean section or instrumental vaginal delivery had worse outcome. In contrast, the lowest complications were seen in the uncomplicated vaginal delivery and elective cesarean section cohorts.

Conclusions:

Neonatal outcome was worse for those delivering via emergency cesarean section or instrumental vaginal delivery compared with elective cesarean section or uncomplicated vaginal delivery. The rate of uncomplicated vaginal delivery, however, was low, with only 14.8% of women delivering both babies vaginally without any form of intervention.
Keyword Cesarean section
Neonatal morbidity
Neonatal outcome
Twins
Vaginal delivery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2016 Collection
School of Medicine Publications
 
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