Twin‐to‐twin delivery time interval: influencing factors and effect on short‐term outcome of the second twin

Stein, W.; Misselwitz, Björn; Schmidt, S.

doi:10.1080/00016340801934276

Cited by 60 publications

(69 citation statements)

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“…In particular, the second twin may have a greater risk of adverse perinatal outcome than the first twin, because of difficulties in delivery due to uterine inertia and abnormal lie or high presentation after the vaginal delivery of the first twin, and increased risk of premature placental separation and cord prolapse 3,4. Although some large-scale epidemiologic studies have reported that there was no difference in the risk of perinatal complications according to birth order 5,6; recent studies have shown that the risk of perinatal mortality and neonatal morbidity was higher in the second twin than the first twin 7,8, and the inter-twin delivery interval have been suggested as an important risk factor associated with the incidence of delivery-related complications in second twins 9.…”

Section: Introductionmentioning

confidence: 99%

Umbilical Arterial Blood Gas and Perinatal Outcome in the Second Twin according to the Planned Mode of Delivery

Kwon¹,

Yoon²,

Lee³

et al. 2011

Int. J. Med. Sci.

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Purpose: To compare umbilical arterial gas parameters in the second twin of twin pregnancies according to the mode of deliveryMethods: We retrospectively analyzed the medical records of twin deliveries after 34 weeks of gestation for 3 years. Excluding the cases which underwent emergency cesarean delivery during trial of labor, a total of 79 twin gestations had umbilical arterial blood gas values available and were and divided into cesarean delivery group (N=40) and vaginal delivery group (N=39). The mean differences of umbilical arterial blood parameters and the Apgar score between the first and second twin in each pregnancy were compared according the mode of delivery.Results: The differences of umbilical arterial gas parameters between twin siblings showed no significant difference according to the mode of delivery. With regard to the 1 minute and 5 minute Apgar scores, the differences between twin siblings are significantly increased in vaginal delivery group compared to cesarean delivery group (p=0.048, and p=0.038, respectively). In comparing the 28 cases delivered vaginally with an inter-twin delivery interval < 10 minutes and 40 cases delivered by cesarean section, no significant differences were observed in the umbilical arterial gas parameters and Apgar scores.Conclusion: The inter-twin umbilical arterial blood gas parameters according to the mode of delivery showed no difference. For twin deliveries, it is relatively safe to plan for a vaginal delivery, but an effort should be made to reduce the inter-twin delivery interval time.

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Section: Introductionmentioning

confidence: 99%

Umbilical Arterial Blood Gas and Perinatal Outcome in the Second Twin according to the Planned Mode of Delivery

Kwon¹,

Yoon²,

Lee³

et al. 2011

Int. J. Med. Sci.

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“…Leung et al ont aussi montré, toujours rétrospectivement, à partir de 51 paires de jumeaux, que les pH artériels de J1 et J2 étaient négativement corrélés avec la durée de la deuxième phase de travail, mais que cette détérioration du pH était plus rapide dans le temps lors de la deuxième phase de travail de J2 (définie comme l'intervalle de naissance entre J1 et J2) que lors de celle de J1 (définie comme l'intervalle entre le début des efforts expulsifs et la naissance de J1) [18]. Ces résultats ont été confirmés par deux autres études dont une française [19,20] [21,22]. Cette option active offre l'avantage de réaliser une manoeuvre obstétricale sur un utérus non tonique, à poche des eaux intacte, et a pour objectif de réduire le risque de rétraction du col, de procidence de cordon, de décollement placentaire, et de survenue d'anomalies du RCF sur J2 [21,22].…”

Section: L'accouchement De J2unclassified

Mode d’accouchement des grossesses gémellaires

Sentilhes

Bouhours

Biquard

et al. 2009

Gynécologie Obstétrique & Fertilité

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“…El intervalo de nacimiento entre gemelos ha sido sugerido como factor de riesgo importante asociado con la incidencia de complicaciones perinatales del segundo nacido (10). En nuestra prác-tica clínica diaria observamos que el pH del cordón del segundo gemelo siempre es igual o menor que el del primero, sobre este hecho postulamos que si el primer gemelo padece un estado acidótico, el estado ácido-base del segundo será igual o más acidótico.…”

Section: Introductionunclassified

Relación entre el intervalo de nacimiento entre gemelos y el pH de cordón umbilical: ¿existe asociación entre la acidosis del primer gemelo y el segundo?

Lago

Martínez

Cortés

et al. 2015

Rev. chil. obstet. ginecol.

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RESUMENObjetivos: Determinar si el intervalo de nacimiento vía vaginal entre gemelos, se relaciona con un descenso de pH arterial/venoso de cordón umbilical del segundo gemelo respecto al primero, y establecer si el pH acidótico del primer gemelo predice la acidosis del segundo. Método: Estudio de cohortes retrospectivo en 77 pares de gemelos realizado en el Hospital de Getafe, España, en el periodo 2008-2013. Se relacionó el tiempo transcurrido entre el nacimiento de los gemelos con el resultado del pH de cordón y el exceso de bases. Estudiamos la correlación entre el tiempo transcurrido entre ambos nacimientos y la diferencia entre los valores de pH del primer y segundo gemelo, y la correlación con la diferencia de exceso de base. Resultados: Hubo correlación lineal significativa entre el tiempo transcurrido entre el nacimiento de los gemelos y la diferencia de pH venoso del segundo gemelo respecto del primero (R=0,560; p=0,0001), así como con el pH arterial (R=0,502; p=0,0001). El pH <7,20 del primer gemelo se asoció con acidosis en el cordón del 2º gemelo (<7,20, p=0,000; <7,15, p=0,0001; <7,10, p=0,0001; <7,05, p=0,001; <7,00, p=0,0001). Conclusiones: El pH del segundo gemelo siempre fue igual o menor que el del primer gemelo, hubo una correlación lineal entre el intervalo de nacimiento entre gemelos y el descenso del pH venoso y arterial del segundo gemelo respecto al primero. El pH acidótico del primer gemelo predice la acidosis del segundo.PALABRAS CLAVE: Intervalo de tiempo en parto gemelar, acidosis fetal, pH de cordón umbilical, estado ácido-base fetal SUMMARYObjectives: Determinate if the twin-to-twin vaginal delivery time interval, is related with a decline of the arterio-venous cord blood pH of the second twin regarding to the first twin, and to evaluate if the acidotic pH of first twin can predict the acidosis status of the second one. Method: A retrospective descriptive cohort study was performed at the Hospital of Getafe, Spain, in the period 2008-2013, with 77 pairs of twins that were registered and met the inclusion criteria. The twin-to-twin delivery time interval and the cord blood status results were registered. A statistical analysis was performed to study the relation of the twin-to-twin delivery time interval with the pH value differences between first and second twins, and with the base excess. Results: A positive linear correlation between the twin-to-twin delivery time interval and the difference of venous pH of the second twin respect to the first one was found (R=0.560; p=0.0001), and also with the difference on arterial pH (R=0.502; p=0.0001). A pH value <7.20 of the first twin was associated with blood cord acidosis of the second twin (<7.20, p=0.000; <7.15, p=0.0001; <7.10, p=0.0001; <7.05, p=0,001; <7.00, p=0.0001). Conclusions: The second twin pH was equal to or less than the first twin pH in all cases.There is a linear relation between twin-to-twin delivery time interval and the decrease of the pH value of the second twin regarding to the first one. The acidosis of first twin ...

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Twin‐to‐twin delivery time interval: influencing factors and effect on short‐term outcome of the second twin

Abstract: As twin-to-twin delivery time interval seems to be an independent risk factor for adverse short-term outcome of the second twin, it should be kept short.

Cited by 60 publications

References 20 publications

Umbilical Arterial Blood Gas and Perinatal Outcome in the Second Twin according to the Planned Mode of Delivery

Umbilical Arterial Blood Gas and Perinatal Outcome in the Second Twin according to the Planned Mode of Delivery

Mode d’accouchement des grossesses gémellaires

Relación entre el intervalo de nacimiento entre gemelos y el pH de cordón umbilical: ¿existe asociación entre la acidosis del primer gemelo y el segundo?

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