Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Int J Gynaecol Obstet. 2021 Apr;153(1):106-112. doi: 10.1002/ijgo.13418. Epub 2020 Nov 4.
To examine the impact of the mode of delivery on neonatal and maternal outcomes in moderately and late preterm twin birth.
This single-center cohort study included 275 live diamniotic moderately and late preterm twin deliveries at 32 -36 weeks of gestation. These twin deliveries were divided into two groups according to the planned mode of delivery: trial of labor (TOL) (N=199, 72.4%) and planned cesarean section (CS) (N=76, 27.6%). The primary outcome was neonatal morbidity. Maternal outcome and the effects of gestational age and chorionicity on neonatal outcome were also studied.
Of the women in the TOL group, 170 (85.4%) delivered vaginally. Both for the first and second twin, and for dichorionic or monochorionic deliveries, there were no differences between the TOL and CS groups in composite neonatal morbidity or in other neonatal outcomes. No significant differences were found between the TOL and CS groups when the moderately and late preterm gestational age cohorts were studied separately. Mothers in the planned CS group more often had puerperal infection and surgical complications in comparison with mothers in the TOL group.
Among 275 moderately and late preterm twin deliveries, planned mode of delivery did not affect neonatal outcome.
探讨分娩方式对中晚期早产儿双胎新生儿和产妇结局的影响。
本单中心队列研究纳入了 275 例孕 32-36 周、活双胎且为单羊膜囊的中晚期早产儿。根据分娩计划方式将这些双胎分娩分为两组：试产组（TOL）（n=199，72.4%）和计划性剖宫产组（CS）（n=76，27.6%）。主要结局是新生儿发病率。还研究了产妇结局以及胎龄和绒毛膜性对新生儿结局的影响。
在 TOL 组中，170 名（85.4%）孕妇经阴道分娩。对于第一和第二胎儿，以及对于双绒毛膜或单绒毛膜分娩，TOL 组与 CS 组在复合新生儿发病率或其他新生儿结局方面没有差异。当分别研究中晚期早产儿胎龄队列时，TOL 组与 CS 组之间也未发现显著差异。与 TOL 组相比，计划性 CS 组的产妇产褥期感染和手术并发症更多。
在 275 例中晚期早产儿双胎分娩中，计划性分娩方式并未影响新生儿结局。
