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. 2021 Jun;303(6):1461-1468.
doi: 10.1007/s00404-020-05882-y. Epub 2020 Nov 21.

Retrospective evaluation of attempted vaginal deliveries in dichorionic twin pregnancies

Sabine Enengl  1 , Peter Oppelt  2 , Simon-Hermann Enzelsberger  2 , Philip Sebastian Trautner  2 , Omar Shebl  2 , Birgit Brandl  3 , Richard Bernhard Mayer  4
Affiliations

Retrospective evaluation of attempted vaginal deliveries in dichorionic twin pregnancies

Sabine Enengl et al. Arch Gynecol Obstet. 2021 Jun.

Abstract

Purpose: Numbers of planned cesarean deliveries are increasing in twin pregnancies, despite the lack of evidence for this approach, and the second twin is thought to be at risk for a poorer outcome. The aim of this study was to examine whether twins have a poorer outcome if an attempted vaginal delivery is changed to a cesarean section or combined delivery.

Methods: This retrospective data analysis included all women with dichorionic twin pregnancies attempting vaginal delivery over a 10-year period. Outcome parameters for the first and second twins relative to their mode of birth were compared. A correlation model between the interdelivery time interval and Apgar scores was calculated. Subgroup analyses assessing the birth mode of the first and second twins were conducted.

Results: A total of 248 women were enrolled in the study. The second twins had significantly lower values for outcome parameters, such as umbilical artery cord pH and Apgar scores in comparison with the first twins (P < 0.01). The subgroup analysis of birth modes in first and second twins showed a significantly poorer outcome in the cesarean section and combined delivery group (P < 0.05). The interdelivery time interval was significantly longer in the second twin cesarean section group (P < 0.01). There was no significant correlation between the interdelivery time intervals and Apgar scores (P > 0.05).

Conclusion: Although outcome parameters were significantly lower in second twins and twins born via secondary cesarean section, the clinical relevance of this appears to be negligible.

Keywords: Birth mode; Multiple pregnancies; Preterm birth; Twin delivery.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Correlation of interdelivery time interval and birth mode of the second twin. Box plots showing the interdelivery time interval (in min) for second twins born via vaginal or cesarean section delivery (P < 0.01). Boxes: interquartile range; horizontal line: median (Q2); whiskers: range; circles: outliers
See this image and copyright information in PMC

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