Ginsberg N A, Levine E M
Northwestern University Medical School, Chicago, IL, USA.
Int J Gynaecol Obstet. 2005 Dec;91(3):217-20. doi: 10.1016/j.ijgo.2005.08.017. Epub 2005 Oct 17.
To determine the likelihood of cesarean for the second twin after vaginal delivery of the first and the risk of vaginal delivery.
A retrospective analysis of twin deliveries was performed on 10,365 live born twin pairs (20,730 births), using birth certificate data from the State of Illinois from 1997 through 2000.
The incidence of cesarean for the second twin after vaginal delivery of the first was 10.1%. The greatest incidence of failed vaginal delivery of the second twin was in the vertex/non-vertex group. Five-minute Apgar scores <4 were significantly more frequent in vaginally delivered twins <2000 g compared to those delivered via cesarean (p<0.001).
Twin presentation type is predictive of the likelihood of a failed vaginal delivery of the second twin. Cesarean appears to significantly reduce the incidence of Apgars <4 for neonates <2000 g.
确定在第一个双胞胎经阴道分娩后，第二个双胞胎进行剖宫产的可能性以及阴道分娩的风险。
利用1997年至2000年伊利诺伊州的出生证明数据，对10365对活产双胞胎（20730次分娩）的双胎分娩进行回顾性分析。
第一个双胞胎经阴道分娩后，第二个双胞胎进行剖宫产的发生率为10.1%。第二个双胞胎阴道分娩失败发生率最高的是头位/非头位组。与剖宫产分娩的双胞胎相比，体重<2000g经阴道分娩的双胞胎5分钟阿氏评分<4的情况明显更频繁（p<0.001）。
双胎胎位类型可预测第二个双胞胎阴道分娩失败的可能性。剖宫产似乎能显著降低体重<2000g新生儿阿氏评分<4的发生率。
