Title :

Is it reasonable to propose vaginal delivery with twin pregnancies, when the first twin is in breech presentation?

Author(s) :

Ghesquière, L. [Auteur]
Département d'obstétrique[Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Rouilles, J. [Auteur]
Département d'obstétrique[Lille]
Drumez, Elodie [Auteur]
Service de Biostatistiques [CHRU Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Debarge, Veronique [Auteur]
Département d'obstétrique[Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Subtil, Damien [Auteur]
Département d'obstétrique[Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Garabedian, Charles [Auteur]
Département d'obstétrique[Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Journal title :

Journal of Gynecology Obstetrics and Human Reproduction

Abbreviated title :

J Gynecol Obstet Hum Reprod

Pages :

102377

Publication date :

2022-04-13

ISSN :

2468-7847

English keyword(s) :

Twin pregnancy
Breech
Mode of delivery

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Breech presentation of the first twin occurs in 20% of twin pregnancies. However, the impact of delivery mode on morbimortality in breech fetuses remains controversial in the literature generally, and has ...
Show more >Background Breech presentation of the first twin occurs in 20% of twin pregnancies. However, the impact of delivery mode on morbimortality in breech fetuses remains controversial in the literature generally, and has been infrequently studied in twin pregnancies specifically. The aim herein was to evaluate neonatal and maternal outcomes according to delivery mode when the first twin was in breech presentation, and to compare these results with those in the current literature. Material and methods This was a single-center, retrospective study in Lille, France, from January 2010 to December 2017, including twin pregnancies in which the first twin was in breech presentation and delivery was after 32 weeks of amenorrhea. Two groups were defined: planned vaginal delivery (PVD) and planned cesarean delivery (PCD). The primary outcome was neonatal morbidities, defined as a 5-minute Apgar score < 7, cord pH < 7.10 at birth, sepsis, and acute respiratory distress syndrome. Results Among the 184 patients included, 116 attempted a vaginal delivery (63%). Morbidity did not differ between PVD and PCD for the first twin (12/116 (10.3%) versus 7/68 (10.3%), respectively, p = 0.99), the second twin (18/116 (15.5%) versus 7/68 (10.3%), respectively, p = 0.31), or either twin (27/116 (23.2%) versus 11/68 (16.2%), respectively, p = 0.25). The rate of postpartum hemorrhage was significantly lower in the PVD group (PVD 36/116 (31%) versus PCD 41/68 (58.8%), p = 0.001). Conclusion PVD is a reasonable option when the first twin is in breech presentation with probably no higher neonatal mortality and morbidity and less risk of maternal severe postpartum hemorrhage.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T04:18:52Z
2024-01-16T09:19:12Z