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Attempted vaginal versus planned cesarean delivery in 195 breech first twin pregnancies.
Acta Obstet Gynecol Scand. 2007; 86(1):55-60.AO

Abstract

BACKGROUND

To compare neonatal and maternal outcomes for breech first twins according to whether vaginal or cesarean delivery was planned and to verify that in appropriate selected cases, attempted vaginal delivery is a reasonable choice.

METHODS

A retrospective study of all twin pregnancies with the first twin in breech position and gestational age at least 35 weeks at birth at two French university hospital centers from January 1994 through December 2000. The primary outcome was a combined indicator of neonatal mortality and severe morbidity, as defined by one or more of the following: death before discharge, admission to neonatal intensive care unit, 5-minute Apgar score <7, cord blood pH <7.10, or birth trauma.

RESULTS

Cesarean delivery was planned for 71 (36.4%) patients, and attempted vaginal delivery for 124 (63.6%), 59 (47.6%) of whom were delivered vaginally and 65 (52.4%) by cesarean during labor. Neither the combined negative outcome indicator nor neonatal mortality differed significantly for either twin or either group. There were no significant differences in maternal mortality or morbidity between the two groups. The frequency of deep vein thrombophlebitis or pulmonary embolism requiring anticoagulant therapy was significantly higher in the planned cesarean group [3/71 (4.2%) versus 0/124; p=0.047].

CONCLUSION

When appropriate criteria are used to decide mode of delivery, a careful intrapartum protocol is followed, and an experienced obstetrician, midwife, and anesthesiologist are in attendance, attempted vaginal delivery is a reasonable option for first twins in breech position.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Rouen University Hospital - Charles Nicolle, Rouen, France. loicsentilhes@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

17230290

Citation

Sentilhes, Loïc, et al. "Attempted Vaginal Versus Planned Cesarean Delivery in 195 Breech First Twin Pregnancies." Acta Obstetricia Et Gynecologica Scandinavica, vol. 86, no. 1, 2007, pp. 55-60.
Sentilhes L, Goffinet F, Talbot A, et al. Attempted vaginal versus planned cesarean delivery in 195 breech first twin pregnancies. Acta Obstet Gynecol Scand. 2007;86(1):55-60.
Sentilhes, L., Goffinet, F., Talbot, A., Diguet, A., Verspyck, E., Cabrol, D., & Marpeau, L. (2007). Attempted vaginal versus planned cesarean delivery in 195 breech first twin pregnancies. Acta Obstetricia Et Gynecologica Scandinavica, 86(1), 55-60.
Sentilhes L, et al. Attempted Vaginal Versus Planned Cesarean Delivery in 195 Breech First Twin Pregnancies. Acta Obstet Gynecol Scand. 2007;86(1):55-60. PubMed PMID: 17230290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attempted vaginal versus planned cesarean delivery in 195 breech first twin pregnancies. AU - Sentilhes,Loïc, AU - Goffinet,François, AU - Talbot,Alain, AU - Diguet,Alain, AU - Verspyck,Eric, AU - Cabrol,Dominique, AU - Marpeau,Loïc, PY - 2007/1/19/pubmed PY - 2007/2/16/medline PY - 2007/1/19/entrez SP - 55 EP - 60 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 86 IS - 1 N2 - BACKGROUND: To compare neonatal and maternal outcomes for breech first twins according to whether vaginal or cesarean delivery was planned and to verify that in appropriate selected cases, attempted vaginal delivery is a reasonable choice. METHODS: A retrospective study of all twin pregnancies with the first twin in breech position and gestational age at least 35 weeks at birth at two French university hospital centers from January 1994 through December 2000. The primary outcome was a combined indicator of neonatal mortality and severe morbidity, as defined by one or more of the following: death before discharge, admission to neonatal intensive care unit, 5-minute Apgar score <7, cord blood pH <7.10, or birth trauma. RESULTS: Cesarean delivery was planned for 71 (36.4%) patients, and attempted vaginal delivery for 124 (63.6%), 59 (47.6%) of whom were delivered vaginally and 65 (52.4%) by cesarean during labor. Neither the combined negative outcome indicator nor neonatal mortality differed significantly for either twin or either group. There were no significant differences in maternal mortality or morbidity between the two groups. The frequency of deep vein thrombophlebitis or pulmonary embolism requiring anticoagulant therapy was significantly higher in the planned cesarean group [3/71 (4.2%) versus 0/124; p=0.047]. CONCLUSION: When appropriate criteria are used to decide mode of delivery, a careful intrapartum protocol is followed, and an experienced obstetrician, midwife, and anesthesiologist are in attendance, attempted vaginal delivery is a reasonable option for first twins in breech position. SN - 0001-6349 UR - https://www.unboundmedicine.com/medline/citation/17230290/Attempted_vaginal_versus_planned_cesarean_delivery_in_195_breech_first_twin_pregnancies_ L2 - https://doi.org/10.1080/00016340601089594 DB - PRIME DP - Unbound Medicine ER -