Improved Perinatal Mortality in Twins--Changing Practice and Technologies.
Am J Perinatol
; 33(1): 84-9, 2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-26295967
ABSTRACT
OBJECTIVE:
We set out to examine rates of perinatal mortality in twin pregnancies over a 17-year study period. Changes in mode of delivery were also examined as well as causes of death in twin mortalities. STUDYDESIGN:
This retrospective cohort study was performed at three large tertiary referral centers from 1996 to 2012. It included all normally formed twin infants with a birth weight more than 500 g. All cases of perinatal mortality in twin pregnancies (infants more than 500 g who suffered an intrauterine or early neonatal (≤ 7 days of age) death were recorded. The changing rate of cesarean delivery as well as varying causes of death in twins over the course of the study were also examined.RESULTS:
During the study period, there were 395,830 pregnancies across the three institutions, this included 6,727 twin gestations. The perinatal mortality rate was 21.5/1,000 twin infants. The perinatal mortality rate in twins decreased over the study period (p = 0.0006; R (2) = 0.55; slope = -1.2). Rates of cesarean delivery in twin gestations were found to have increased over the course of the study (p < 0.0001; R (2) = 0.84; slope = 1.7). There were 288 intrauterine and early neonatal deaths in twin infants, 50% (147/288) occurred in twins born extremely premature (< 26 weeks). Prematurity was the leading cause of mortality in twins, followed by twin-to-twin transfusion syndrome (TTTS). TTTS was found to have a decreasing contribution to perinatal mortality during the study (p = 0.008; R (2) = 0.38; slope = -1.5).CONCLUSION:
The perinatal mortality rate in twins improved during the study. The rate of cesarean delivery increased by 1.7% for each year of the study, culminating in a cesarean delivery rate of 62% in 2012. TTTS made a decreasing contribution to the mortality rate in twins during the study.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cesárea
/
Recém-Nascido de Peso Extremamente Baixo ao Nascer
/
Mortalidade Perinatal
/
Transfusão Feto-Fetal
/
Gravidez de Gêmeos
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Newborn
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
Am J Perinatol
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Irlanda