Objectives:To study modes of delivery and neonatal morbidity of twins as a function of their presentation. Study design:The study related to 614 consecutive patientswho gave birth to twins in the maternity ward of th...Objectives:To study modes of delivery and neonatal morbidity of twins as a function of their presentation. Study design:The study related to 614 consecutive patientswho gave birth to twins in the maternity ward of the Hpital Robert Debréfrom 1992 to 2000. Group A (n = 529) included patients who gave birth after 33 weeks of gestation and group B (n = 85) before 33 weeks. The parameters studied were the mode of delivery,the need for intubation at birth,5-min Apgar score < 9,transfer to intensive care,death in the neonatal period. The chi-square test was used for statistical analysis. Results:In group A,significantly more cesarean sections were performed for breech-breech (22.6%)-and breech-vertex (16%) presentations than for vertex-vertex (10.3%) and vertex-breech (4.6%) presentations. In group B,there was no significant difference in the rate of vaginal delivery. Second vertex twins of group A had significantly higher frequencies of intubation (3%) at birth and transfer to intensive care (3%) than the vertex first twins born by vaginal delivery (p = 0.01). These percentages were not significantly different from those observed for the second twins born by planned Cesarean section before the start of labor (2.8 and 5.6%,respectively). In group B,neonatal parameters did not differ significantly with the type of presentation at delivery. Conclusions:The type of presentation should not influence the choice of mode of delivery of twin pregnancies,whatever the gestational age.展开更多
文摘Objectives:To study modes of delivery and neonatal morbidity of twins as a function of their presentation. Study design:The study related to 614 consecutive patientswho gave birth to twins in the maternity ward of the Hpital Robert Debréfrom 1992 to 2000. Group A (n = 529) included patients who gave birth after 33 weeks of gestation and group B (n = 85) before 33 weeks. The parameters studied were the mode of delivery,the need for intubation at birth,5-min Apgar score < 9,transfer to intensive care,death in the neonatal period. The chi-square test was used for statistical analysis. Results:In group A,significantly more cesarean sections were performed for breech-breech (22.6%)-and breech-vertex (16%) presentations than for vertex-vertex (10.3%) and vertex-breech (4.6%) presentations. In group B,there was no significant difference in the rate of vaginal delivery. Second vertex twins of group A had significantly higher frequencies of intubation (3%) at birth and transfer to intensive care (3%) than the vertex first twins born by vaginal delivery (p = 0.01). These percentages were not significantly different from those observed for the second twins born by planned Cesarean section before the start of labor (2.8 and 5.6%,respectively). In group B,neonatal parameters did not differ significantly with the type of presentation at delivery. Conclusions:The type of presentation should not influence the choice of mode of delivery of twin pregnancies,whatever the gestational age.
