Cesarean delivery for twins: A systematic review and meta-analysis

Hogle, Karen L.; Hutton, Eileen K.; McBrien, Kerry; Barrett, Jon; Hannah, Mary E.

doi:10.1067/mob.2003.64

Cited by 177 publications

(145 citation statements)

References 68 publications

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“…24 -26 Potential reasons for the high rate of cesarean section are a high incidence of gestational hypertension, twin pregnancy, and older maternal age. 19,27,28 Preterm delivery in the studied patients (25%) was higher than the rate of 4% to 8% published recently for healthy women 29 and probably was due to the increased incidence of gestational hypertension and twin pregnancies. 19,27 …”

Section: Obstetrical and Neonatal Outcomecontrasting

confidence: 41%

“…17,18 The rate of twin pregnancy reported in our study, 13%, was markedly higher than the normal rate of 1% to 2% in healthy women. 19 This interesting association between PPCM and twin pregnancies may support an autoimmune mechanism for PPCM. Such a mechanism has recently been proposed by Ansari et al, 20 who found high titers of autoantibodies against normal human cardiac tissue proteins in the sera of PPCM patients that were not present in patients with idiopathic cardiomyopathy.…”

Section: Discussion Clinical Profile Of Ppcmmentioning

confidence: 99%

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Pregnancy-Associated Cardiomyopathy

et al. 2005

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Background-Cardiomyopathy associated with pregnancy was first described more than half a century ago. However, because of its rare occurrence and geographical differences, the clinical profile of this condition has remained incompletely defined. Methods and Results-Data obtained from 123 women with a history of cardiomyopathy diagnosed during pregnancy or the postpartum period were reviewed. One hundred women met traditional criteria of peripartum cardiomyopathy; 23 were diagnosed with pregnancy-associated cardiomyopathy earlier than the last gestational month. Peripartum cardiomyopathy patients had a mean age of 31Ϯ6 years and were mostly white (67%). Common associated conditions were gestational hypertension (43%), tocolytic therapy (19%), and twin pregnancy (13%). Left ventricular ejection fraction at the time of diagnosis was 29Ϯ11% and improved to 46Ϯ14% (PՅ0.0001) at follow-up. Normalization of left ventricular ejection fraction occurred in 54% and was more likely in patients with left ventricular ejection fraction Ͼ30% at diagnosis. Maternal mortality was 9%. A comparison between the peripartum cardiomyopathy and early pregnancy-associated cardiomyopathy groups revealed no differences in age, race, associated conditions, left ventricular ejection fraction at diagnosis, its rate and time of recovery, and maternal outcome.

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Section: Obstetrical and Neonatal Outcomecontrasting

confidence: 41%

Section: Discussion Clinical Profile Of Ppcmmentioning

confidence: 99%

Pregnancy-Associated Cardiomyopathy

et al. 2005

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“…Prenatal diagnosis of twin gestation in early gestation by ultrasonography can alert the obstetrician regarding need for more vigilance during antenatal period.It can also help in counseling the patient regarding possibility of adverse perinatal outcome. 10,11 Present study was undertaken to analyze the maternal and fetal outcome in twin gestations and to find out various factors that contribute to adverse perinatal outcome.…”

Section: Introductionmentioning

confidence: 99%

Study Of Maternal And Fetal Outcome In Twin Gestation At Tertiary Care Teaching Hospital

Bangal¹,

Patel²,

Khairnar³

2012

Int J of Biomed & Adv Res

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Twin gestation is considered as high risk pregnancy due to associated high maternal morbidity and perinatal mortality in comparison with singleton pregnancies .Overall, the rate of twin gestation is on rise due to inadvertent use of ovulation induction drugs in assisted reproductive techniques. This observational study was carried out to find the maternal and perinatal outcome in 100 cases of twin gestation delivered at tertiary care referral hospital over a period of fifteen months. It was observed that the incidence of twins was 1.49 % .Seventy six percent cases were booked and attended antenatal clinic on regular basis .Preterm labour (84%) was the commonest obstetric complication ,whereas ,nutritional anemia (66%) and pregnancy induced hypertension (18%) were the commonest medical complications .The rate of caesarean section was 33%.There was no serious maternal morbidity or mortality .There were 35 perinatal deaths ,of which 20 were early neonatal deaths. Extreme prematurity (37%) and very low birth weight (33%) predisposed majority of perinatal deaths. Causes of neonatal deaths were respiratory distress, fulminant septicemia ,pulmonary hemorrhage and DIC. Judicious use of ovulation induction drugs can reduce the incidence of twin gestation. Early diagnosis of twin gestation with its chorionicity, careful monitoring for fetal wellbeing throughout the pregnancy ,regular antenatal checkups, adequate rest, good diet, cervical encirclage in selective cases, maternal gluco-corticoids therapy in preterm labour, short term tocolysis and institutional delivery having level III neonatal back up facilities can improve the maternal and perinatal outcome in twin gestation.

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“…This used to be seen as a failure of obstetric management and reflected badly on the obstetrician who resorted to it. However, the practice occurred in 2.8% in our study, 3.5% of twin births in the UK [4], 4.3% in a Canadian study [14], 0.5% in study of Schmitz et al [8], 0% in Fox et al [3], and 17% in Alexander et al [15], so it is, therefore, widespread. While any caesarean section at full dilatation carries risks for the mother (which may be increased in twin delivery), emergency caesarean section may be the preferred option if the alternative is an internal maneuver by an inexperienced operator.…”

Section: Discussionmentioning

confidence: 94%

The Planned Mode of Delivery and Neonatal Outcomes of Uncomplicated Dichorionic Twin pregnancies

Sagr¹,

Elrifaei²,

Al-M³

et al. 2013

Gynecol Obstet

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Background: The incidence of twins worldwide continues to increase. The intrapartum management of twins is a major area of risk in obstetrics, and the optimal mode of delivery is a subject of continuing debate, this can affect the physician counseling, and maternal requests for elective cesarean delivery. Planned caesarean delivery could theoretically avoid some of the risks but direct evidence of a protective effect is currently lacking. Moreover, cesarean delivery before the onset of labor is associated with an increased risk of neonatal respiratory morbidity.

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Cesarean delivery for twins: A systematic review and meta-analysis

Cited by 177 publications

References 68 publications

Pregnancy-Associated Cardiomyopathy

Pregnancy-Associated Cardiomyopathy

Study Of Maternal And Fetal Outcome In Twin Gestation At Tertiary Care Teaching Hospital

The Planned Mode of Delivery and Neonatal Outcomes of Uncomplicated Dichorionic Twin pregnancies

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