The influence of breach position of the second twinon perinatal outcomes in vaginal births of bichorial - biamniotic twins after 33rd week of gravidity


Authors: V. Ťápalová;  L. Hruban;  P. Janků;  P. Ventruba;  I. Vlašínová;  Z. Hodická;  I. Rejdová
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc., MBA
Published in: Čes. Gynek.2014, 79, č. 5 s. 350-355

Overview

Objective:
The objective is to evaluate whether a breach presentation of the second twin has an influence on the perinatal results in vaginal births of bichorial-biamniotic twins after 33rd week of pregnancy.

Design:
Retrospective analysis.

Setting:
Department of Obstetrics and Gynecology, Masaryk University and University Hospital Brno.

Sample and methods:
The current study is a retrospective analysis of 695 vaginal births of bichorial-biamniotic twins after 33rd week of pregnancy. All births were conducted at the Department of Obstetrics and Gynecology, Masaryk University and University Hospital Brno during the span of 2004–2013. The sample was divided into2 groups. Group A consisted of 550 births of both twins in vertex presentation, group B consisted of 145 births in which the second twin happened to be in the breach presentation. The factors that have been evaluated include the percentage of births finished vaginally, perinatal results (pH a. umbilicalis below 7.0 and Apgar score in the 5th minute below 5) and early neonatal mortality and morbidity. Data from both groups have been compared with the use of Fisher‘s exact test.

Results:
For the group A, 81.3% of births were finished vaginally, as opposed to 85.5% in group B. Acute Caesarean sections conducted on the second twin consisted 4% (22 cases) in group A and 3.4% (5 cases) in group B. No significant difference has been found between the two groups in both perinatal results (p = 0.6 for pH from a. umbilicalis below 7.0 and p = 0.7 for Apgar score in the 5th minute below 5; both two-tailed) and in the frequency of early neonatal mortality and morbidity. In total,5 neonatal deaths have occured in 28 days after birth, out of which 2 have occured in group A and 3 in group B.

Conclusion:
It was concluded that breach presentation of the second twin does not influence perinatal results in vaginal births of bichorial-biamniotic twins.

Keywords:
bichorial-biamniotic twins, vaginal birth, breach presentation, perinatal mortality, perinatal morbidity


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Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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