מתוך medicontxt.co.il
NEW YORK (Reuters Health) – A prolonged interdelivery interval and nonvertex presentation of the second twin are the strongest risk factors for combined vaginal-cesarean deliveries among twin gestations, Canadian investigators report.
According to data from the Nova Scotia Atlee Perinatal database, more than 100,000 deliveries took place between 1980 and 1999 at a single hospital in Halifax. Of these deliveries, 1151 were twin pregnancies without major congenital abnormalities, antenatal fetal deaths, or monoamniotic or conjoined twins, Dr. Vidia L. Persad and associates of the Dalhousie University in Halifax report.
Fifty twin sets were delivered by combined vaginal-cesarean procedures, they report in the December issue of Obstetrics and Gynecology. Combined deliveries increased from 2.0% in the first 5-year epoch to 6.5% during the fourth such epoch.
Malpresentation was the reason for combined deliveries in 20 cases. Indications were failure to descend in 11 cases, cord prolapse in 9 cases, fetal distress in 9 cases, and placenta previa in 1 case.
The relative risk for combined delivery compared with vaginal-vaginal deliveries was 8.2 for situations in which the interdelivery interval exceeded 60 minutes. A two-fold higher risk of cesarean delivery accompanied nonvertex presentation for the second twin. Having a second twin >500 grams heavier than the first was associated with a relative risk of 1.9 for combined delivery.
תגובות רוצה להצטרף לדיון?
יש להתחבר כדי להגיב.
התחבראין תגובות עדיין. היה הראשון להגיב!