June 18th, 2018

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Effect of Mode of Delivery on Neonatal Outcome of Monochorionic Diamniotic Twin Pregnancies: A Retrospective Cohort Study
Authors:  Inês Pestana, M.D., Teresa Loureiro, M.D., Ph.D., Amélia Almeida, M.D., Ilda Rocha, M.D., Rosa Maria Rodrigues, M.D., and Teresa Rodrigues, M.D., Ph.D.
  OBJECTIVE: To assess whether vaginal delivery increases the risk of adverse neonatal outcome among uneventful monochorionic diamniotic twin pregnancies.

STUDY DESIGN: We conducted a retrospective controlled cohort study on 112 uneventful monochorionic diamniotic twin pregnancies at ≥ 34 weeks’ gestation. The outcomes of 52 monochorionic diamniotic twins delivered vaginally were compared with those of 172 monochorionic diamniotic twins delivered by cesarean section.

RESULTS: Five babies (2.9%) in the cesarean section group had a 5-minute Apgar score <7 and needed orotracheal intubation, whereas in the vaginal delivery group no 5-minute Apgar score <7 or orotracheal intubation occurred (p=0.002). Delivery by cesarean section presented higher rates of admission to neonatal intensive care unit (62 out of 172 babies delivered by cesarean section compared to 3 out of 52 babies delivered vaginally, p<0.001). There were no cases of intrapartum twin-to-twin transfusion syndrome or neonatal death at time of hospital discharge in either group.

CONCLUSION: Vaginal delivery appears to be a good management option in uneventful monochorionic diamniotic twin pregnancies after 34 weeks’ gestation.
Keywords:  mode of delivery, monochorionic diamniotic twins, neonatal outcome, obstetric delivery, twin, vaginal delivery
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