Breech presenting twin A: is vaginal delivery safe?
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Anwar H. Nassar
Abstract
The aim of our study was to compare the neonatal outcome of vaginally delivered breech-presenting twins (VD) to those delivered by cesarean (CS). Maternal and neonatal charts of all live, non-anomalous twins delivered at ≥25 weeks of gestation, in a single tertiary care center, over an 11-year period were reviewed. Of 517 twins delivered, 130 breech-presenting twins were analyzed. Thirty-five (26.9%) were delivered vaginally and 95 (73.1%) by cesarean. More patients presented in labor with advanced cervical dilation in the VD compared to the CS group. There was no difference in the incidence of respiratory distress syndrome, intraventricular hemorrhage, need for mechanical ventilation, length of nursery stay or neonatal mortality rate when twin A was compared in the two groups. However, one breech-presenting twin in the VD group had a traumatic delivery at 32 weeks of gestation that caused a spine fracture followed by immediate neonatal death. Although there seems to be no compromise in the immediate neonatal outcome of breech-presenting twins delivered vaginally compared to those delivered by cesarean, the case of head entrapment that led to intrapartum death is quite alarming. Based on our study, we cannot advocate normal vaginal delivery when twin A is non-vertex: cesarean seems to be a safer route of delivery.
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© Walter de Gruyter
Articles in the same Issue
- Author Index
- Subject Index
- Contents
- Difficult delivery of the impacted fetal head during cesarean section: intraoperative disengagement dystocia
- Breech presenting twin A: is vaginal delivery safe?
- Maternal serum interleukin-1β, -6 and -8 levels and potential determinants in pregnancy and peripartum
- Comparison between HELLP syndrome, chronic hypertension, and superimposed preeclampsia on chronic hypertension without HELLP syndrome
- Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to CTG. A multi-center, observational study
- Effects of nitric oxide and prostacyclin on hemodynamic response by big endothelin-1 in near term fetal sheep
- Strategy for management of newborns with cervical teratoma
- Predicting neonatal outcomes: birthweight, body mass index or ponderal index?
- Markers of platelets activation, CD 62P and soluble P-selectin in healthy term neonates
- Detection of parvovirus B19, cytomegalovirus and enterovirus infections in cases of intrauterine fetal death
- Plasma endothelin-1 and clinical manifestations of neonatal sepsis
- Noncompaction of the left ventricular myocardium diagnosed in pregnant woman and neonate
- Ventricular bigeminy misdiagnosed as fetal bradycardia by cardiotocography – the value of non-invasive fetal electrocardiography
- Prolonged fetal bradycardia as the presenting clinical sign in Streptococcus agalactiae chorioamnionitis
- Changes of blood pressure and heart rate variability precede a grand mal seizure in a pregnant woman
- Myocardial infarction in early pregnancy
- The baby and the bathwater – a comment
- Reply to the opinion paper “The baby or the bathwater: which one should be discarded?”
Articles in the same Issue
- Author Index
- Subject Index
- Contents
- Difficult delivery of the impacted fetal head during cesarean section: intraoperative disengagement dystocia
- Breech presenting twin A: is vaginal delivery safe?
- Maternal serum interleukin-1β, -6 and -8 levels and potential determinants in pregnancy and peripartum
- Comparison between HELLP syndrome, chronic hypertension, and superimposed preeclampsia on chronic hypertension without HELLP syndrome
- Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to CTG. A multi-center, observational study
- Effects of nitric oxide and prostacyclin on hemodynamic response by big endothelin-1 in near term fetal sheep
- Strategy for management of newborns with cervical teratoma
- Predicting neonatal outcomes: birthweight, body mass index or ponderal index?
- Markers of platelets activation, CD 62P and soluble P-selectin in healthy term neonates
- Detection of parvovirus B19, cytomegalovirus and enterovirus infections in cases of intrauterine fetal death
- Plasma endothelin-1 and clinical manifestations of neonatal sepsis
- Noncompaction of the left ventricular myocardium diagnosed in pregnant woman and neonate
- Ventricular bigeminy misdiagnosed as fetal bradycardia by cardiotocography – the value of non-invasive fetal electrocardiography
- Prolonged fetal bradycardia as the presenting clinical sign in Streptococcus agalactiae chorioamnionitis
- Changes of blood pressure and heart rate variability precede a grand mal seizure in a pregnant woman
- Myocardial infarction in early pregnancy
- The baby and the bathwater – a comment
- Reply to the opinion paper “The baby or the bathwater: which one should be discarded?”
