Second twin outcome at birth: retrospective analysis in a single tertiary centre in Malaysia.
J Perinat Med
; 52(4): 385-391, 2024 May 27.
Article
in En
| MEDLINE
| ID: mdl-38511669
ABSTRACT
OBJECTIVES:
To investigate factors associated with outcome of second twin during labour.METHODS:
The study was a retrospective cohort study in a single tertiary centre in Malaysia from 2014 until 2018 involving all twin pregnancies delivered at or more than 24 weeks of gestation.RESULTS:
Total of 409 twin pregnancies were included. Dichorionic twin comprises of 54.5â¯% (n=223) and 45.5â¯% (n=186) are monochorionic. Women with dichorionic pregnancies are significantly older (p<0.001), have more pre-existing medical disorders (p=0.011) and fetal structural anomalies (p=0.009). Monochorionic pregnancies are significantly more amongst Malay (p=0.01) and conceived spontaneously (p<0.001). There are significantly more fetuses both in cephalic presentation (p=0.026), birthweight discrepancy more than 20â¯% (p=0.038) and shorter mean inter-twin delivery duration (p=0.048) in monochorionic pregnancies. Second twin delivered with Apgar score <7 is significantly more in dichorionic pregnancies (p=0.006). The second twin is associated with lower birthweight, small for gestational age and arterial cord pH<7.25. Within the group of women who delivered both fetuses vaginally, there was significantly more second twins with intertwin delivery duration less than 30â¯min who were delivered vaginally without instrumentation (p=0.018). There was significantly more second twin with intertwin delivery duration of 30â¯min and more with arterial cord pH<7.25 (p=0.045). Those who delivered spontaneously had inter-twin delivery duration within 15-29â¯min. The outcome of second twin is not influenced by type of twin, gestational age at delivery, inter-twin delivery duration, mode of delivery and presentation at birth.CONCLUSIONS:
The neonatal outcome for the second twin at birth is not influenced by type of twin, gestational age at delivery, inter-twin delivery duration, mode of delivery and presentation at birth in a cohort managed with non-active management of the second twin in Malaysia.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pregnancy Outcome
/
Pregnancy, Twin
Limits:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
Country/Region as subject:
Asia
Language:
En
Journal:
J Perinat Med
Year:
2024
Type:
Article
Affiliation country:
Malaysia