Gynecology & Obstetrics
Open Access

Abstract

The Planned Mode of Delivery and Neonatal Outcomes of Uncomplicated Dichorionic Twin pregnancies

Emad R Sagr, Rabab M Elrifaei, Hazem Mahmoud AL-Mandeel and Khalid AL-Hussein

Background: The incidence of twins worldwide continues to increase. The intrapartum management of twins is a major area of risk in obstetrics, and the optimal mode of delivery is a subject of continuing debate, this can affect the physician counseling, and maternal requests for elective cesarean delivery. Planned caesarean delivery could theoretically avoid some of the risks but direct evidence of a protective effect is currently lacking. Moreover, cesarean delivery before the onset of labor is associated with an increased risk of neonatal respiratory morbidity.

Objectives: Is to compare the neonatal outcomes in planned vaginal and planned cesarean delivery of uncomplicated dichorionic twin pregnancies at 37-38 weeks.

Methods: This study was conducted at tertiary-care, Security Forces Hospital, Kingdom Saudi Arabia, about mode of delivery and neonatal outcome of 500 patients with uncomplicated dichorionic twin pregnancies at 37-38 weeks, during the period from November 2005 to October 2010.

Results: Out of 500 included in this study, only 202 patients were completed the study. 108 (53.4%) patients were in the planned vaginal delivery group, and 94 (46.6%) were in the planned cesarean group. In the planned vaginal delivery group, 23 (21.3%) had an emergency cesarean delivery. The overall cesarean rate was 117 out of 202 (57.9%). There was no significant difference in a 5-minute Apgar score lower than 7, an arterial cord pH below 7.20, and admission to NICU of the neonates between both groups.

Conclusion: Planned vaginal and planned cesarean delivery of uncomplicated dichorionic twin pregnancies at 37-38 weeks has the same neonatal outcomes.