Effect of twin‐to‐twin delivery interval on umbilical cord blood gas in the second twins

Leung, Tse Ngong; Tam, Wing Hung; Leung, T.; Lok, Ingrid Hung; Lau, Tze Kin

doi:10.1111/j.1471-0528.2002.01159.x

Cited by 98 publications

(75 citation statements)

References 9 publications

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“…These observations have been supported by another cohort study that found a higher risk of metabolic acidosis of the second twin after a TTDT of more than 60 minutes (Edris et al, 2006). These data are in line with those of a study of 118 patients showing a significant correlation between all umbilical cord blood gas parameters of the second twin and TTDT (Leung et al, 2002). Like us, Leung also focused on those twin pairs at or beyond 34 weeks of gestation and vaginal delivery of twin I.…”

Section: Discussionsupporting

confidence: 77%

Twin-to-Twin Delivery Time: Neonatal Outcome of the Second Twin

et al. 2011

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Objective: To examine the effect of twin-to-twin delivery time (TTDT) on neonatal outcome. Methods: We evaluated twin deliveries >34 weeks of gestation. Twin pregnancies with both twins delivered by cesarean section and pregnancies with antenatal complications were excluded. We analyzed TTDT and neonatal outcomes of the second twin (umbilical arterial pH value (pH art ), Apgar scores at 1, 5 and 10 minutes, need for intensive care). The study population was divided into two homogenous groups based on the mode of delivery: (A) vertex presentation and vaginal delivery of both twins, (B) vertex presentation and vaginal or vaginal operative delivery of twin I, breech or transverse presentation and vaginal breech delivery or cesarean section (CS) of twin II. Results: A total of 207 twin pairs were included in our study. In Group A (n = 151) there were no significant correlations between TTDT and pH art or Apgar scores at 1,5 and 10 minutes of twin II (p = .156; 0.861; 0.151 and 0.384, respectively). In Group B (n = 56), the mean pH art of twin II was inversely correlated to TTDT, but not significantly (p = .417). TTDT was inversely related to 1-min and 5-min Apgar scores, but not significantly (p = .330; p = .138, respectively). The 10-min Apgar score showed no correlation with TTDT (p = .638). Conclusion: Increasing TTDT was not associated with adverse fetal outcome. Expectant management of the second twin appears possible and elapsed time alone does not appear to be an indication for intervention.

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Section: Discussionsupporting

confidence: 77%

Twin-to-Twin Delivery Time: Neonatal Outcome of the Second Twin

et al. 2011

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“…Respecto a estudios previamente publicados con un objeto similar de estudio, algunos autores concluyen que el pH del segundo gemelo es más bajo que el del primero (1,3,7,11-16) y parece deteriorarse con más rapidez (17), también describen una correlación negativa entre el intervalo de nacimiento entre gemelos y las diferencias en el pH de ambos gemelos o el valor del pH de cordón del segundo (11,(17)(18)(19)(20). Sin embargo, no tienen en consideración el estado ácido-base del primer gemelo, ni el deterioro del pH de cordón umbilical del segundo gemelo respecto al primero.…”

Section: Discussionunclassified

Relación entre el intervalo de nacimiento entre gemelos y el pH de cordón umbilical: ¿existe asociación entre la acidosis del primer gemelo y el segundo?

Lago

Martínez

Cortés

et al. 2015

Rev. chil. obstet. ginecol.

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RESUMENObjetivos: Determinar si el intervalo de nacimiento vía vaginal entre gemelos, se relaciona con un descenso de pH arterial/venoso de cordón umbilical del segundo gemelo respecto al primero, y establecer si el pH acidótico del primer gemelo predice la acidosis del segundo. Método: Estudio de cohortes retrospectivo en 77 pares de gemelos realizado en el Hospital de Getafe, España, en el periodo 2008-2013. Se relacionó el tiempo transcurrido entre el nacimiento de los gemelos con el resultado del pH de cordón y el exceso de bases. Estudiamos la correlación entre el tiempo transcurrido entre ambos nacimientos y la diferencia entre los valores de pH del primer y segundo gemelo, y la correlación con la diferencia de exceso de base. Resultados: Hubo correlación lineal significativa entre el tiempo transcurrido entre el nacimiento de los gemelos y la diferencia de pH venoso del segundo gemelo respecto del primero (R=0,560; p=0,0001), así como con el pH arterial (R=0,502; p=0,0001). El pH <7,20 del primer gemelo se asoció con acidosis en el cordón del 2º gemelo (<7,20, p=0,000; <7,15, p=0,0001; <7,10, p=0,0001; <7,05, p=0,001; <7,00, p=0,0001). Conclusiones: El pH del segundo gemelo siempre fue igual o menor que el del primer gemelo, hubo una correlación lineal entre el intervalo de nacimiento entre gemelos y el descenso del pH venoso y arterial del segundo gemelo respecto al primero. El pH acidótico del primer gemelo predice la acidosis del segundo.PALABRAS CLAVE: Intervalo de tiempo en parto gemelar, acidosis fetal, pH de cordón umbilical, estado ácido-base fetal SUMMARYObjectives: Determinate if the twin-to-twin vaginal delivery time interval, is related with a decline of the arterio-venous cord blood pH of the second twin regarding to the first twin, and to evaluate if the acidotic pH of first twin can predict the acidosis status of the second one. Method: A retrospective descriptive cohort study was performed at the Hospital of Getafe, Spain, in the period 2008-2013, with 77 pairs of twins that were registered and met the inclusion criteria. The twin-to-twin delivery time interval and the cord blood status results were registered. A statistical analysis was performed to study the relation of the twin-to-twin delivery time interval with the pH value differences between first and second twins, and with the base excess. Results: A positive linear correlation between the twin-to-twin delivery time interval and the difference of venous pH of the second twin respect to the first one was found (R=0.560; p=0.0001), and also with the difference on arterial pH (R=0.502; p=0.0001). A pH value <7.20 of the first twin was associated with blood cord acidosis of the second twin (<7.20, p=0.000; <7.15, p=0.0001; <7.10, p=0.0001; <7.05, p=0,001; <7.00, p=0.0001). Conclusions: The second twin pH was equal to or less than the first twin pH in all cases.There is a linear relation between twin-to-twin delivery time interval and the decrease of the pH value of the second twin regarding to the first one. The acidosis of first twin ...

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“…Il n'existe pas de données scientifiques en faveur d'un tel examen. Quatre-vingt-dix-huit pour cent des répondants conseillent une analgésie péridurale qui faciliterait les gestes obstétricaux et permettrait de réduire le risque d'avoir une césarienne en cours de travail selon Williams et al [32] [33]. On sait aussi que J2 à terme serait à plus haut risque que J1 de mourir au cours du travail (n = 2436 jumeaux à terme), en particulier par anoxie per-partum (p = 0,02) [34].…”

Section: Discussionunclassified