To compare the neonatal outcome of vaginally delivered (VD) to that of abdomin ally delivered (CS) vertex-nonvertex (Vx/NVx)-twins. Vx/NVx live nonanomalous twin gestations ≥25 weeks delivered from 1984 to 2000 were ...To compare the neonatal outcome of vaginally delivered (VD) to that of abdomin ally delivered (CS) vertex-nonvertex (Vx/NVx)-twins. Vx/NVx live nonanomalous twin gestations ≥25 weeks delivered from 1984 to 2000 were divided into two gro ups: VD (N=138), and CS (N=79). The outcome of the second twin was compared. The vaginal delivery rate for the Vx/NVx twins was 63.6%. The median Apgar scores at 1 and 5 min, respectively, were significantly lower in VD [7 (0-9) and 9 (1 -10)] compared to CS [8 (2-10) and 9 (2-10)]. The neonatal mortality was also higher in VD (109/1000 vs. 38/1000, p=0.040). Differences in the 1-min Apgar s cores persisted when infants <1500 g were excluded. All other neonatal outcome v ariables studied including respiratory distress syndrome, necrotizing enterocoli tis, intraventricular hemorrhage, trauma, seizures, and length of nursery stay w ere similar. On logistic regression analysis, vaginal delivery of Vx/NVx twins m arginally increased low 5-min Apgar scores and neonatal deaths. Vaginal deliver y in vertex-nonvertex twins was achieved in 63.6%of cases at the expense of a higher incidence of low 1-and 5-min Apgar scores and neonatal death.展开更多
文摘To compare the neonatal outcome of vaginally delivered (VD) to that of abdomin ally delivered (CS) vertex-nonvertex (Vx/NVx)-twins. Vx/NVx live nonanomalous twin gestations ≥25 weeks delivered from 1984 to 2000 were divided into two gro ups: VD (N=138), and CS (N=79). The outcome of the second twin was compared. The vaginal delivery rate for the Vx/NVx twins was 63.6%. The median Apgar scores at 1 and 5 min, respectively, were significantly lower in VD [7 (0-9) and 9 (1 -10)] compared to CS [8 (2-10) and 9 (2-10)]. The neonatal mortality was also higher in VD (109/1000 vs. 38/1000, p=0.040). Differences in the 1-min Apgar s cores persisted when infants <1500 g were excluded. All other neonatal outcome v ariables studied including respiratory distress syndrome, necrotizing enterocoli tis, intraventricular hemorrhage, trauma, seizures, and length of nursery stay w ere similar. On logistic regression analysis, vaginal delivery of Vx/NVx twins m arginally increased low 5-min Apgar scores and neonatal deaths. Vaginal deliver y in vertex-nonvertex twins was achieved in 63.6%of cases at the expense of a higher incidence of low 1-and 5-min Apgar scores and neonatal death.
