Clinical factors affecting the timing of delivery in twin pregnancies

Lee, Chae Min; Yang, Sunhye; Lee, Sun Pyo; Hwang, Byung Chul; Kim, Suk Young

doi:10.5468/ogs.2014.57.6.436

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…Multiple pregnancies present a higher incidence of maternal and fetal adverse outcomes compared to singleton ones [ 3 , 9 – 13 ]. Twin pregnancies account for 12.2% of preterm births and 15.4% of neonatal deaths [ 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of weight gain, according to Institute of Medicine 2009 recommendation, on spontaneous preterm delivery in twin pregnancies

Algeri

Pelizzoni

Bernasconi

et al. 2018

BMC Pregnancy Childbirth

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BackgroundsMaternal total weight gain during pregnancy influences adverse obstetric outcomes in singleton pregnancies. However, its impact in twin gestation is less understood. Our objective was to estimate the influence of total maternal weight gain on preterm delivery in twin pregnancies.MethodsWe conducted a retrospective cohort study including diamniotic twin pregnancies with spontaneous labor delivered at 28 + 0 weeks or later. We analyzed the influence of total weight gain according to Institute of Medicine (IOM) cut-offs on the development of preterm delivery (both less than 34 and 37 weeks). Outcome were compared between under and normal weight gain and between over and normal weight gain separately using Fisher’s exact test with Holm-Bonferroni correction.ResultsOne hundred seventy five women were included in the study and divided into three groups: under (52.0%), normal (41.7%) and overweight gain (6.3%). Normal weight gain was associated with a reduction in the rate of preterm delivery compared to under and over weight gain [less than 34 weeks: under vs. normal OR 4.97 (1.76–14.02), over vs. normal OR 4.53 (0.89–23.08); less than 37 weeks: OR 3.16 (1.66–6.04) and 6.51 (1.30–32.49), respectively].ConclusionsNormal weight gain reduces spontaneous preterm delivery compared to over and underweight gain.

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Section: Introductionmentioning

confidence: 99%

Influence of weight gain, according to Institute of Medicine 2009 recommendation, on spontaneous preterm delivery in twin pregnancies

Algeri

Pelizzoni

Bernasconi

et al. 2018

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…In our study, out of total deliveries, 61.4% were preterm which is very similar to the study conducted by MD Michael O Gardner et al [10] in which 54% of twins were preterm compared with 9.6% among singletons. Chae Min Lee et al [11] in his study found that the mean duration of pregnancy for twin gestations was 29.5 weeks, and deliveries at less than 36 weeks were 76.1%.…”

Section: Discussionmentioning

confidence: 95%

Doppler velocimetry in dichorionic twin pregnancies and its correlation with various fetal outcome

et al. 2017

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Aim: This study was to evaluate the applicability of Doppler velocimetry to determine its correlation with fetal outcome in dichorionic twin pregnancies. Material and methods: Doppler examination of the umbilical artery (UA) and middle cerebral artery (MCA) was performed in 57 twin pairs. Abnormal values of the umbilical artery pulsatility index (PI), umbilical artery Resistive index (RI) were above the 95th percentile and below 5th percentile for the Middle cerebral artery pulsatility index (MCA PI) and Middle cerebral artery resistivity index (MCA RI) for gestational week. The difference of UA PI ≥0.5 in twin pairs was considered abnormal. Results: 33 subjects had a fetal discordance of greater than 15%. Birth weight was found to be significantly lower in subjects with Umbilical artery PI greater than 95 th percentile for gestational age (p=0.014). Abnormal MCA RI (P=0.018) and Umbilical artery RI values above 95 th percentile was significantly associated with increased risk of IUGR (intra uterine growth restriction) (P=0.036) and NICU (Neonatal intensive care unit) admission (P=0.005). Increased Umbilical artery PI values above 95 th percentile was significantly associated with IUGR (P=0.003). Increased Umbilical Artery systolic/diastolic ratio above 95 th percentile was significantly associated with IUGR (P=0.002), NICU admission (P=0.026) and still birth (P=0.026). Abnormal cerebra-umbilical ratio (<1.08) was significantly associated with IUGR (P=0.001) and still birth (P=0.025). Difference in pulsatility index of umbilical artery of both fetus (P1-P2 >0.5) was significantly correlated with increased degree of birth weight discordance of the twins, IUGR (P=0.001) and still birth (P=0.001). Conclusion: Abnormal Doppler values in discordant twin fetus are more likely to be associated with abnormal fetal outcome.

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“…This possibility is supported by the larger proportion of late preterm births among the prematurity population and the lower proportion of twins with birth weight discordance. In addition, in the case of twins, unlike that of singletons, the delivery time is determined according to chorionicity and amnionicity [ 12 , 13 ]. The American College of Obstetricians and Gynecologists suggested that obstetricians consider delivering twins in the preterm to early term according to their chorionicity.…”

Section: Discussionmentioning

confidence: 99%