Startseite Adverse perinatal outcomes related to the delivery mode in women with monochorionic diamniotic twin pregnancies
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Adverse perinatal outcomes related to the delivery mode in women with monochorionic diamniotic twin pregnancies

  • Akiko Yamashita , Keisuke Ishii EMAIL logo , Takako Taguchi , Aki Mabuchi , Shiyo Ota , Jun Sasahara , Syusaku Hayashi und Nobuaki Mitsuda
Veröffentlicht/Copyright: 11. April 2014

Abstract

Aims: The association between the planned delivery mode and adverse perinatal outcomes of monochorionic diamniotic (MCDA) twin pregnancies at ≥36 weeks’ gestation was evaluated.

Methods: This retrospective cohort study included uncomplicated MCDA twin pregnancies delivered after 36 weeks’ gestation during a 10-year period. Cases were classified into the trial of labor (TOL) or cesarean section (CS) group according to the planned delivery mode. The primary outcome was a composite of adverse outcomes for at least one twin, including intrauterine fetal death (IUFD) after 36 weeks, neonatal death, umbilical artery pH<7.1, 5-min Apgar scores<7, hypoxic ischemic encephalopathy (HIE), meconium aspiration syndrome (MAS), respiratory distress syndrome (RDS), or acute feto-fetal hemorrhage (AFFH). The relationship between outcomes and the planned delivery mode was evaluated using a multiple logistic regression analysis.

Results: We included the 310 pregnancies delivered after 36 weeks’ gestation. After excluding 15 patients, the final analysis included 295 MCDA pregnancies: 63% had delivered through TOL and 37% through CS. The incidences of composite adverse outcomes in the TOL and CS groups were 4.3% and 1.9%, respectively. No IUFD, neonatal death, MAS, RDS, or AFFH was observed; two infants in each group developed HIE. Adverse outcomes were not significantly associated with any risk factor, including delivery through TOL.

Conclusion: TOL may not influence the perinatal outcomes of MCDA twin pregnancies delivered at ≥36 weeks’ gestation.


Corresponding author: Dr. Keisuke Ishii, MD, Osaka Medical Center and Research, Department of Maternal Fetal Medicine, 840 Murodo Izumi, Osaka, Japan, Tel.: +81-725-56-1220, Fax: +81-725-57-3207, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-2-27
Accepted: 2014-3-24
Published Online: 2014-4-11
Published in Print: 2014-11-1

©2014 by De Gruyter

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