Atis A, Aydin Y, Donmez M, Sermet H
Third Obstetrics and Gynecology Department, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
J Obstet Gynaecol. 2011;31(1):43-7. doi: 10.3109/01443615.2010.522748.
Our study was undertaken to determine whether caesarean section for the second of cephalic/non-cephalic presenting twins may prevent or diminish neonatal morbidity. For this study, 482 cephalic/non-cephalic presenting twins admitted to our hospital were retrospectively evaluated. They were separated into two groups according to their delivery mode: vaginal or caesarean delivery. Records of Apgar score (<7) at 5 min, seizure occurrence, neonatal intensive care unit (NICU) admission and duration, need for mechanical ventilation and perinatal mortality of second twins were compared. Second fetuses' mortality rates of the two groups were similar. NICU admission rate and duration, seizure and mechanical ventilation necessity rates of second fetuses were similar for both groups. Only 5 min Apgar score rates of the vaginal group were lower than the caesarean group. Caesarean section for cephalic/non-cephalic presenting twins does not decrease morbidity scores but provides effective improvement on morbidity of second fetus, according to Apgar scores.
我们开展这项研究是为了确定头位/非头位双胎中第二个胎儿行剖宫产是否可预防或降低新生儿发病率。在本研究中,我们对我院收治的482名头位/非头位双胎进行了回顾性评估。根据分娩方式将他们分为两组:阴道分娩或剖宫产。比较了5分钟时阿氏评分(<7分)、惊厥发生情况、新生儿重症监护病房(NICU)入住情况及时长、机械通气需求以及第二个胎儿的围产期死亡率。两组中第二个胎儿的死亡率相似。两组中第二个胎儿的NICU入住率及时长、惊厥及机械通气需求率相似。仅阴道分娩组的5分钟阿氏评分率低于剖宫产组。根据阿氏评分,头位/非头位双胎行剖宫产虽不会降低发病率评分,但能有效改善第二个胎儿的发病率。