Predictors of adverse perinatal outcome in twins delivered at &lt; 37 weeks

Vergani, Patrizia; Locatelli, Anna; Ratti, Marta; Scian, Antonietta; Zangheri, Giulia; Pezzullo, John C.; Ghidini, Alessandro

doi:10.1080/14767050400018254

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…Similar findings were reported by Amaru, et al, 23 Bagchi and Salihu. 24 As reported by Vergani P, 25 the present study also emphasizes the influence of gestational age at delivery and birth weight discordance are the important independent predictors of neonatal morbidity among preterm twins.…”

Section: Discussionsupporting

confidence: 80%

Comparative Study on Neonatal Outcome Between First and Second Twin Babies Delivered by Vaginal Route

Naskar¹

2019

jebmh

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BACKGROUNDExisting observations show that the second twin is at higher risk of morbidity and mortality compared to the first foetus because of obstetric complications that may occur after delivery of the first twin. A noticeable gap has been observed in statistical analysis of the same in Indian context. We wanted to analyse and establish the neonatal outcome between first and second twin. METHODSThis is a prospective comparative study based on sample calculation based on 60 cases of twin pregnancies, 18-35 years of age, with more than 32 weeks of gestation where first twin was of cephalic presentation. Patients were in active labour and mode of delivery was vaginal. The key observation focuses on RDS development based on mother's age, gravida, parity, gestation week, presentation, mode of delivery, sex, birth weight discrepancy, delivery interval, APGAR score, Down scoring, number of antenatal corticosteroid doses and ventilation requirement. RESULTSResults indicates that the delivery between 32-34 weeks causes RDS in first and second twin is 43% and 60%, respectively. In addition to this, sepsis development was observed in 16% and 22%, convulsions in 5% and 6% for first and second twin respectively. RDS development of second twin significantly depends on mother's gravida (p = 0.038), number of antenatal corticosteroid doses (p = 0.044), and ventilation needed by the twins (p = 0.044). CONCLUSIONSRDS severity is more in second twin than the first twin. Completed dose of antenatal corticosteroid reduces the risk of RDS.HOW TO CITE THIS ARTICLE: Naskar A, Sinha A, Das RK. Comparative study on neonatal outcome between first and second twin babies delivered by vaginal route.

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Section: Discussionsupporting

confidence: 80%

Comparative Study on Neonatal Outcome Between First and Second Twin Babies Delivered by Vaginal Route

Naskar¹

2019

jebmh

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“…Routine CS is not recommended only because of prematurity (8, 10, 11, 13). Systematic review performed by Dagenais C et al suggested that on the safest MD for extremely preterm vertex/non-vertex presentation twins found very limited existing evidence, without significant differences in neonatal death and severe brain injury in relation to MD (14-15).…”

Section: Discussionmentioning

confidence: 99%

Mode of Delivery in Preterm Births - Bosnian and Herzegovinian Experience

Cerovac¹,

Grgić

Ljuca

2018

Mater Sociomed

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Introduction: The method of carrying out PTB is one of the most controversial topics of modern perinatology, because there are no clear and undeniable works and studies that would in any case support vaginal delivery (VD) or delivery to the cesarean section (CS). Aim: To determine more frequent mode of delivery in different groups of birth weights and degrees of prematurity from single and twin pregnancies. To determine the degree of vitality of premature born vaginal delivery (VD) in relation to the cesarean section (CS) in different degrees of prematurity from single and twin pregnancies. Patients and methods: Research has retrospective cohort character. Data were collected from the databases of University Clinic of Gynecology and Obstetrics Tuzla for the period of five years (January 1st, 2012–December 31st, 2016). The study included newborns of both genders, gestational age from 24 to 37 weeks of gestation (WG) in singleton and twin pregnancies. Results: Out of 19506 births, 1350 (6.92%) were preterm birth (PTB). Singleton PTB was 1180 (87.40%), and the twins were 170 (12.59%). Vaginal delivery (VD) was born 788 (58.37%). Cesarean section (CS) was born 562 (41.63%). There was statistically significant association between the mode of delivery (MD) in singleton and twins pregnancy in all three subgroups of birth weight (BW) 1000-1499, 2000-2499 and >2500 grams in 33-37 WG. In this group was more frequent VD than CS mode of singleton delivery, and CS than VD mode of twins delivery. In contrast to newborn with BW 1500-1999 grams (chi-square = 23.16, P <0.0001) in same gestational period where was more frequent CS than VD (OR: 2.56, 95% CI: 1.71-3,85). Apgar score (AS) at first and five minute 5-7 and 8-10 in the period 28-32 and 33-37 was a statistically significant frequent in VD and singletons in contrast to CS and twins. Conclusion: VD was more frequent in the higher WG, as well as the higher AS in singletons in contrast to twins delivery.

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“…Twin pregnancies are associated with higher risks of adverse pregnancy outcomes than singleton pregnancies [8][9][10]. In 1990, the Institute of Medicine (IOM) introduced guidelines for gestational weight gain in twin pregnancies so as to lower the risks of adverse pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

Gestational weight gain charts for twin pregnancies in Southeast China

Lin

Mao

et al. 2020

BMC Pregnancy Childbirth

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Background: To establish age-standardized charts of weight gain for term twin pregnancies in Southeast China. Methods: We designed a retrospective study on data from women pregnant with twins, a gestational age beyond 36 weeks and an average weight ≥ 2500 g. We established hierarchical linear regression models to express gestational weight gain patterns. Results: We analyzed data from 884 women pregnant with twins (151 underweight, 597 normal weight, and 136 overweight). Our final models fit the crude weight measurement data well. The means of weight gain generally decreased as the pre-pregnancy BMI increased. For each BMI category, the mean weight gains increased with the gestational age and the standard deviation increased slightly. The mean weight gains were 18.82 ± 6.73, 18.53 ± 6.74, and 16.97 ± 6.95 kg at 37 weeks in underweight, normal weight, and overweight women, respectively. Conclusion: The weight gain chart can be used to estimate maternal weight gain to be gestational agestandardized z scores by pre-pregnancy BMI and may serve as an innovative tool for perinatal care providers to guide the weight gain of women pregnant with twins.

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Predictors of adverse perinatal outcome in twins delivered at < 37 weeks

Abstract: Gestational age at delivery and birth weight discordance are the most important independent predictors of perinatal mortality or morbidity among preterm twins.

Cited by 11 publications

References 14 publications

Comparative Study on Neonatal Outcome Between First and Second Twin Babies Delivered by Vaginal Route

Comparative Study on Neonatal Outcome Between First and Second Twin Babies Delivered by Vaginal Route

Mode of Delivery in Preterm Births - Bosnian and Herzegovinian Experience

Gestational weight gain charts for twin pregnancies in Southeast China

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