Influence of mode of delivery on twin births

Abstract

The mode of delivery and outcome in 158 twin births in a Nigerian sub-urban hospital are reviewed. Apgar scores at one minute were significantly higher for twin 1 compared to twin 2 in vertex deliveries only. There was no significant difference in Apgar scores at 5 minutes between the twins for the various modes of delivery. Apgar scores were generally higher for the controls (a set of singleton births) compared to twin births for all the modes of delivery except breech births. Birth weights were also significantly higher for controls compared to twin births although no significant difference occurred between the twins. Perinatal mortality rates were generally higher for twin 2 compared to twin 1, and for the twins compared to controls irrespective of mode of delivery. Better outcome could not be ascribed to any particular mode of delivery in twin births and would depend on the judgement and expertise of the labour attendant.

PIP: The mode of delivery of twin pregnancies depends mainly upon the presentation and lie of the fetuses as well as the skills of the labor attendant. The various modes of delivery in twin gestation in a Nigerian suburban hospital were studied to establish the relationship, if any, between such modes and Apgar scores, parity, birth weights, and perinatal mortality. 158 twin births conducted between January 1986 and December 1990 at Iyi-Enu Mission Hospital, Ogidi, Anambra State, were analyzed. Vertex, breech, assisted using obstetric forceps or ventouse, and Cesarean section deliveries occurred. 56.3% of twin 1, 41.1% of twin 2, and 83.8% of controls were born through vertex deliveries. Apgar scores at 1 minute were significantly higher for twin 1 compared to twin 2 in vertex deliveries only. There was no significant difference in Apgar scores at 5 minutes between the twins for the various modes of delivery. Apgar scores were generally higher for the singleton controls compared to twin births for all modes of delivery except breech births. Birth weights were also significantly higher for controls compared to twin births, although no significant difference occurred between the twins. Perinatal mortality rates were generally higher for twin 2 compared to twin 1, and for the twins compared to controls regardless of mode of delivery. Better outcome could be attributed to no particular mode of delivery in twin births and would depend upon the judgement and expertise of the labor attendant.