Malfertheiner, S. Fill and Weigl, M. and Dudakova, A. and Seelbach-Goebel, B. (2018) Birth management and fetal outcome in multiple gestation: analysis of 1.444 births. ARCHIVES OF GYNECOLOGY AND OBSTETRICS, 297 (1). pp. 61-69. ISSN 0932-0067, 1432-0711
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Purpose Since the late 1990s, controversies came up concerning the mode of delivery for multiples births. The twin birth study indicated no difference in maternal and fetal outcome between planned vaginal delivery and planned caesarean section, but did not analyze the influence of maternal and fetal characteristics or the obstetric management in vaginal birth. The purpose of this study is to analyze these parameters regarding fetal outcome. Methods A large-scale retrospective analysis of twin births (n = 1.444) was performed at a university medical center. The analysis included pregnancy, delivery, and maternal and fetal parameters, including pH and base excess ( BE) differences between the first-and second-born twin (delta pH, delta BE). Results Delta pH correlated significantly with the birth interval for various positions of twins in the womb (p < 0.05). The longer the birth interval, the greater the delta pH with a lower pH of the second twin. Delta BE values were significantly correlated with the birth interval for a combination of twins in cephalic and breech presentation. Furthermore, it could be shown that higher differences in birth weight between the first/second twin are associated with higher delta pH, higher delta BE values (all p < 0.05). We found significantly decreasing delta pH values in vaginal deliveries over secondary and, finally, primary caesarean sections (p < 0.001). Conclusion We conclude a vaginal delivery of twin appears safe if experienced staff monitor birth weight discrepancies, birth interval, and blood values consequently. A good outcome also for the second twin delivered spontaneously is nevertheless feasible if experienced staff is available.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CORD BLOOD-GAS; TWIN DELIVERY TIME; PRETERM BIRTH; NEONATAL OUTCOMES; VAGINAL DELIVERY; PERINATAL-MORTALITY; CESAREAN DELIVERY; APGAR SCORES; 2ND TWINS; MODE; Multiple gestation; Twin gestation; Fetal outcome; Birth management; APGAR score |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Geburtshilfe) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Mar 2020 06:11 |
| Last Modified: | 23 Mar 2020 06:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15465 |
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