Second twin outcome at birth: retrospective analysis in a single tertiary centre in Malaysia
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Rahana Abd Rahman
,
Azmawati Mohammed Nawi
Abstract
Objectives
To investigate factors associated with outcome of second twin during labour.
Methods
The study was a retrospective cohort study in a single tertiary centre in Malaysia from 2014 until 2018 involving all twin pregnancies delivered at or more than 24 weeks of gestation.
Results
Total of 409 twin pregnancies were included. Dichorionic twin comprises of 54.5 % (n=223) and 45.5 % (n=186) are monochorionic. Women with dichorionic pregnancies are significantly older (p<0.001), have more pre-existing medical disorders (p=0.011) and fetal structural anomalies (p=0.009). Monochorionic pregnancies are significantly more amongst Malay (p=0.01) and conceived spontaneously (p<0.001). There are significantly more fetuses both in cephalic presentation (p=0.026), birthweight discrepancy more than 20 % (p=0.038) and shorter mean inter-twin delivery duration (p=0.048) in monochorionic pregnancies. Second twin delivered with Apgar score <7 is significantly more in dichorionic pregnancies (p=0.006). The second twin is associated with lower birthweight, small for gestational age and arterial cord pH<7.25. Within the group of women who delivered both fetuses vaginally, there was significantly more second twins with intertwin delivery duration less than 30 min who were delivered vaginally without instrumentation (p=0.018). There was significantly more second twin with intertwin delivery duration of 30 min and more with arterial cord pH<7.25 (p=0.045). Those who delivered spontaneously had inter-twin delivery duration within 15–29 min. The outcome of second twin is not influenced by type of twin, gestational age at delivery, inter-twin delivery duration, mode of delivery and presentation at birth.
Conclusions
The neonatal outcome for the second twin at birth is not influenced by type of twin, gestational age at delivery, inter-twin delivery duration, mode of delivery and presentation at birth in a cohort managed with non-active management of the second twin in Malaysia.
Acknowledgments
The authors thank all staff who were directly or indirectly involved in the research.
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Research ethics: The local Institutional Review Board deemed the study exempt from review.
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Informed consent: Not applicable.
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Author contributions: AMN, AHK: contributed to the interpretation of data, the conception of the manuscript. RAR, KB, SI, MAA: conception and design of the study, acquisition of data, analysis and interpretation of data, data management and contributed to the content of the manuscript, and manuscript editing. AMN: contributed to the interpretation of the data and presentation of data in the manuscript. AHK, NAM, SHAA, ZAM, SA also contributed to the conception and the final form of the manuscript. All authors read and approved the final manuscript.
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Competing interests: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: The raw data can be obtained on request from the first author.
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© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Corner of Academy
- The outcome of reduced and non-reduced triplet pregnancies managed in a tertiary hospital during a 15-year-period – a retrospective cohort study
- Original Articles – Obstetrics
- Parental refusal of prenatal screening for aneuploidies
- Analysis of maternal mortality in Berlin, Germany – discrepancy between reported maternal mortality and comprehensive death certificate exploration
- Second twin outcome at birth: retrospective analysis in a single tertiary centre in Malaysia
- Incidence and first trimester risk factors of stillbirth in Indonesia
- Correlation of fetal heart rate dynamics to inflammatory markers and brain-derived neurotrophic factor during pregnancy
- Preliminary assessment of the Healthy Early Life Moments (HELMS) webinars in empowering Developmental Origins of Health and Disease (DOHaD) concept among healthcare professionals – a pragmatic serial cross-sectional study
- Original Articles – Fetus
- The changing Doppler patterns and perinatal outcomes of monochorionic diamniotic twins with selective fetal growth restriction
- Effects of umbilical vein flow on midbrain growth and cortical development in late onset fetal growth restricted fetuses: a prospective cross-sectional study
- Original Articles – Neonates
- Prediction of bronchopulmonary dysplasia by the chest radiographic thoracic area on day one in infants with exomphalos
- Impact of birth weight to placental weight ratio and other perinatal risk factors on left ventricular dimensions in newborns: a prospective cohort analysis
- Changes in regional tissue oxygen saturation values during the first week of life in stable preterm infants
- Letters to the Editor
- Optimal closure of the uterus during cesarean section: beyond the two layers
- Reply to: “Optimal closure of the uterus during cesarean section: beyond the two layers” commenting on “The effect of uterine closure technique on cesarean scar niche development after multiple cesarean deliveries”
Articles in the same Issue
- Frontmatter
- Corner of Academy
- The outcome of reduced and non-reduced triplet pregnancies managed in a tertiary hospital during a 15-year-period – a retrospective cohort study
- Original Articles – Obstetrics
- Parental refusal of prenatal screening for aneuploidies
- Analysis of maternal mortality in Berlin, Germany – discrepancy between reported maternal mortality and comprehensive death certificate exploration
- Second twin outcome at birth: retrospective analysis in a single tertiary centre in Malaysia
- Incidence and first trimester risk factors of stillbirth in Indonesia
- Correlation of fetal heart rate dynamics to inflammatory markers and brain-derived neurotrophic factor during pregnancy
- Preliminary assessment of the Healthy Early Life Moments (HELMS) webinars in empowering Developmental Origins of Health and Disease (DOHaD) concept among healthcare professionals – a pragmatic serial cross-sectional study
- Original Articles – Fetus
- The changing Doppler patterns and perinatal outcomes of monochorionic diamniotic twins with selective fetal growth restriction
- Effects of umbilical vein flow on midbrain growth and cortical development in late onset fetal growth restricted fetuses: a prospective cross-sectional study
- Original Articles – Neonates
- Prediction of bronchopulmonary dysplasia by the chest radiographic thoracic area on day one in infants with exomphalos
- Impact of birth weight to placental weight ratio and other perinatal risk factors on left ventricular dimensions in newborns: a prospective cohort analysis
- Changes in regional tissue oxygen saturation values during the first week of life in stable preterm infants
- Letters to the Editor
- Optimal closure of the uterus during cesarean section: beyond the two layers
- Reply to: “Optimal closure of the uterus during cesarean section: beyond the two layers” commenting on “The effect of uterine closure technique on cesarean scar niche development after multiple cesarean deliveries”
