Tang Hiu Tung, Liu Ah Lai, Chan Sum Yee, Lau Chin Ho, Yung Wai Kuen, Lau Wai Lam, Leung Wing Cheong
a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
J Matern Fetal Neonatal Med. 2016;29(7):1094-100. doi: 10.3109/14767058.2015.1035640. Epub 2015 Apr 20.
To determine any change in adverse neonatal/maternal outcomes after increasing the rate of vaginal twin delivery by comparing vaginal twin delivery and caesarean delivery with our previous cohort study.
In a retrospective cohort study, all twins booked at a Hong Kong regional obstetrics unit were evaluated during a 3-year period from 1 April 2009 to 31 March 2012.
Out of the 269 sets of twins who eventually delivered in our unit, 68 (25.3%) of them were delivered vaginally, compared to 15.8% in our previous cohort study (p = 0.02). For those who were suitable for vaginal delivery, significantly more women attempted vaginal delivery: 93/133 (69.9%) versus 47/100 (47%) (p = 0.0005). The success rate for vaginal delivery and rate of requiring caesarean delivery for the 2nd twin were similar between these two periods. There were significantly more 2nd twins with cord blood pH < 7.2 when both twins were delivered by vaginal delivery. Otherwise, there was no significant difference between other neonatal/maternal morbidities.
With proper counseling, significantly more women who were suitable for vaginal twin delivery would opt to do so. There was no significant increase in neonatal/maternal morbidities despite the increased rate of vaginal twin delivery.
通过将阴道分娩双胎与剖宫产分娩与我们之前的队列研究进行比较，确定提高阴道分娩双胎率后新生儿/产妇不良结局的任何变化。
在一项回顾性队列研究中，对2009年4月1日至2012年3月31日这3年期间在香港某地区产科单位登记的所有双胎进行评估。
在我们单位最终分娩的269对双胎中，68对（25.3%）通过阴道分娩，而我们之前的队列研究中这一比例为15.8%（p = 0.02）。对于适合阴道分娩的产妇，尝试阴道分娩的女性显著增多：93/133（69.9%）对47/100（47%）（p = 0.0005）。这两个时期阴道分娩成功率和第二胎剖宫产率相似。当两个胎儿均经阴道分娩时，第二胎脐血pH<7.2的情况明显更多。除此之外，其他新生儿/产妇发病率之间无显著差异。
经过适当的咨询，适合阴道分娩双胎的女性会有显著更多的人选择这样做。尽管阴道分娩双胎率有所提高，但新生儿/产妇发病率并未显著增加。
