Open AccessIntrapartum management of twin pregnancies: are uncomplicated monochorionic pregnancies more at risk of complications than dichorionic pregnancies?
Author(s) -
Garabedian Charles,
Poulain Chloe,
Duhamel Alain,
Subtil Damien,
HoufflinDebarge Veronique,
Deruelle Philippe
Publication year - 2015
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12558
Subject(s) - medicine , obstetrics , umbilical artery , umbilical cord , retrospective cohort study , vaginal delivery , monochorionic twins , gynecology , population , twin pregnancy , pregnancy , gestational age , gestation , surgery , environmental health , anatomy , biology , genetics
Abstract Objective To analyze mode of delivery and neonatal morbidity according to chorionicity in a hospital birth center with a policy of vaginal delivery for twins. Study design Retrospective analysis over a 13‐year period. Setting Department of Obstetrics, University Hospital, Lille, France. Population In all, 1009 twin pregnancies were included, divided into 171 uncomplicated monochorionic pregnancies (17%) and 838 dichorionic pregnancies (83%). Methods We compared the monochorionic and the dichorionic populations. Main outcome measures Rate of cesarean section and neonatal outcome (umbilical artery pH , Apgar score and neonatal complications). Results The rate of cesarean sections was 45.7% with no difference found based on chorionicity. The reasons for elective cesarean section were mainly noncephalic presentation, which was more frequent in dichorionic than in monochorionic (48.8% vs. 37.2%, p = 0.025) pregnancies. Birthweight was lower in monochorionic twins (2249 ± 469 g vs. 2329 ± 478 g, p = 0.045). The rate of umbilical artery cord blood values with a pH < 7.10 was similar in monochorionic and dichorionic pregnancies. There was no difference in neonatal complications between the two groups. Conclusion Monochorionic and dichorionic twin pregnancies had similar delivery outcomes. The neonatal outcome for twin 2 was not different between monochorionic and dichorionic pregnancies. Vaginal birth could be offered to women with twin pregnancies regardless of chorionicity.