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

Published online by Cambridge University Press:  21 February 2012

Susanne Schneuber ,
Eva Magnet ,
Josef Haas ,
Albrecht Giuliani ,
Thomas Freidl ,
Uwe Lang  and
Vesna Bjelic-Radisic
Susanne Schneuber*
Affiliation:
Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
Eva Magnet
Affiliation:
Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
Josef Haas
Affiliation:
Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
Albrecht Giuliani
Affiliation:
Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
Thomas Freidl
Affiliation:
Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria
Uwe Lang
Affiliation:
Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
Vesna Bjelic-Radisic
Affiliation:
Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria
*
ADDRESS FOR CORRESPONDENCE: Susanne Schneuber, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, A-8036 Graz, Austria. E-mail: susanne.schneuber@medunigraz.at

Abstract

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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 (pHart), 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 pHart 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 pHart 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.

Keywords

twinstwin-to-twin delivery timeumbilical arterial pHneonatal outcome
Type
Articles
Information
Twin Research and Human Genetics , Volume 14 , Issue 6 , December 2011 , pp. 573 - 579
Copyright
Copyright © Cambridge University Press 2011

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