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Internal Version Compared With Pushing for Delivery of Cephalic Second Twins
- Source :
- Obstetrics and Gynecology, Obstetrics and Gynecology, Lippincott, Williams & Wilkins, 2020, 135 (6), pp.1435-1443. ⟨10.1097/AOG.0000000000003862⟩
- Publication Year :
- 2020
-
Abstract
- International audience; OBJECTIVE: To assess neonatal morbidity and mortality according to whether cephalic second twins were born after internal version followed by total breech extraction or after instructions to push. We hypothesized that interval version would result in shorter intertwin delivery intervals and lower cesarean delivery rates for the second twin and therefore better neonatal outcomes. METHODS: These planned analyses of the JUMODA (JUmeaux MODe d'Accouchement) cohort, a national prospective population-based study of twin deliveries, examined births of cephalic second twins after vaginal birth of the first twin at or after 32 weeks of gestation. The internal version group of second twins born in breech presentation after obstetric maneuvers was compared with the pushing group, comprising those born in cephalic presentation. The primary outcome was a composite of neonatal morbidity and mortality. Multivariate modified Poisson regression models were used to control for potential confounders. RESULTS: Of 2,256 cephalic second twins, 487 (21.6%) were born in breech presentation after internal version and total breech extraction and 1,769 (78.4%) in cephalic presentation after pushing. Composite neonatal morbidity and mortality was not lower in the internal version (17/487 [3.5%]) compared with the pushing group (38/1,769 [2.1%]; adjusted relative risk [aRR] 1.73 [95% CI 0.98-3.05]), although median [quartile 1-quartile 3] intertwin delivery intervals were shorter (5 [4-8] vs 8 [5-12] minutes, P
- Subjects :
- Adult
medicine.medical_specialty
[SDV]Life Sciences [q-bio]
Population
Twins
Gestational Age
1ST
03 medical and health sciences
MORBIDITY
0302 clinical medicine
Breech presentation
Pregnancy
Infant Mortality
medicine
MANAGEMENT
Humans
030212 general & internal medicine
MODE
Prospective Studies
education
Prospective cohort study
Breech Presentation
education.field_of_study
030219 obstetrics & reproductive medicine
business.industry
Obstetrics
NEONATAL-MORTALITY
Cesarean Section
Cephalic presentation
VAGINAL DELIVERY
CESAREAN DELIVERY
Infant, Newborn
Obstetrics and Gynecology
Gestational age
Infant
medicine.disease
Delivery, Obstetric
3. Good health
Quartile
Relative risk
Multivariate Analysis
Pregnancy, Twin
Regression Analysis
Female
France
business
Subjects
Details
- ISSN :
- 1873233X and 00297844
- Volume :
- 135
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Obstetrics and gynecology
- Accession number :
- edsair.doi.dedup.....27aaafd9410a8b403263e026a57f834b