The Association between Intended Mode of Delivery and Maternal Morbidity in Twin Pregnancies

Zafman, Kelly B.; Naqvi, Mariam; Melka, Stephanie; Miller, James M.; Rebarber, Andrei; Fox, Nathan S.

doi:10.1055/s-0038-1673655

Cited by 1 publication

(5 citation statements)

References 14 publications

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“…A total of 788 twin pregnancies between 2005 and 2018 were included in a recent study that was conducted by Zafman et al, and no differences were reported between delivery types and maternal mor-tality and morbidity. [9] There were rare serious maternal complications in the same study such as thrombosis, hysterectomy, bowel or bladder injury, and admission to ICU, and there were no differences between the groups. [9] Also, there were no significant differences between 3rd and 4th-degree laceration, endometritis, wound complications, and blood transfusion rates.…”

Section: Discussionmentioning

confidence: 76%

“…[9] There were rare serious maternal complications in the same study such as thrombosis, hysterectomy, bowel or bladder injury, and admission to ICU, and there were no differences between the groups. [9] Also, there were no significant differences between 3rd and 4th-degree laceration, endometritis, wound complications, and blood transfusion rates. [9] In our study, the complications such as thrombosis, endometritis, hysterectomy, bowel or bladder injury, and blood transfusions were rare in the groups, and we found no differences between the groups in this respect.…”

Section: Discussionmentioning

confidence: 76%

“…[9] Also, there were no significant differences between 3rd and 4th-degree laceration, endometritis, wound complications, and blood transfusion rates. [9] In our study, the complications such as thrombosis, endometritis, hysterectomy, bowel or bladder injury, and blood transfusions were rare in the groups, and we found no differences between the groups in this respect. Except that postpartum hemorrhage was increased in the CS group in the study of Easter et al, our results were consistent with the results of the studies of Zafman et al and Eastern et al Although the rates of wound infection and endometritis were similar between the groups, longer hospitalization also increased the risk of hospital-transmitted infection.…”

Section: Discussionmentioning

confidence: 78%

“…[8] However, many obstetricians still prefer Cesarean section (CS) for deliveries in twin pregnancies due to the concerns on neonatal complications, including cord prolapse, abruptio placentae, and hypoxic damage in the second twin in VD. [9] Twin pregnancies are classified at high risk because of higher maternal and perinatal morbidity rates when compared to singleton pregnancies. [10] One of the biggest reasons for this high risk is preterm birth.…”

Section: Introductionmentioning

confidence: 99%

“…When compared with singleton pregnancies, twins have increased maternal rates for postpartum bleeding, postpartum hysterectomy, and a slightly increased risk of death. [9] Determining the optimal delivery type is critical in minimizing the risk of these adverse outcomes. A randomized controlled study conducted to compare twin pregnancies who gave birth by CS and VD in women who had twin pregnancies did not report any significant differences in maternal outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of maternal and neonatal outcomes in twin pregnancies according to delivery types: vaginal delivery or Cesarean delivery?

Turan¹,

Çetin²,

Turgut³

et al. 2022

Perinat J

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Objective: Our aim was to compare the maternal and neonatal outcomes of twin pregnancies, which result in vaginal delivery (VD) and Cesarean section (CS), and the factors affecting the decision of CS. Methods: Twin pregnancies between 30 and 39 weeks who gave birth in a tertiary center were included in the present study. The demographic data and maternal and neonatal outcomes of the patient groups who gave birth <32 weeks, 32–37 weeks, and >37 weeks were recorded and compared according to the type of birth. Results: A total of 1209 patients were included in the study. The 1- and 5-minute Apgar scores of the 1st and 2nd fetuses in twin pregnancies <32 weeks of gestation were higher in the CS group at a statistically significant level (p=0.007, p=0.010, p=0.001, and p=0.003, respectively). The 1- and 5-minute Apgar scores of the 2nd fetuses of the pregnant women >37 weeks of age were higher in the VD group at a statistically significant level (p=0.039 and p=0.032, respectively). The newborn intensive care unit (NICU) admission rates of 1st fetus and 2nd fetus in the groups of <32 weeks, 32–37 weeks, and >37 weeks were higher in those born by CS at a statistically significant level when compared to those born by VD (1st fetus p<0.001, p<0.001, p=0.016, respectively; 2nd fetus p<0.001, p<0.001, p=0.012, respectively). Conclusion: It must be kept in mind that twin pregnancies have high risks. However, vaginal delivery can be considered as a safe and reasonable option in appropriately selected cases and in the presence of experienced obstetricians by being careful about maternal and neonatal complications which might occur.

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Section: Discussionmentioning

confidence: 76%