Zedini Chekib, Bannour Rania, Bannour Imen, Bannour Badra, Jlassi Majdi, Goul Leila, Khairi Hedi
Department of Family and Community Medicine, Faculty of Medicine, Sousse, 4000 Sousse, Tunisia.
Faculty of Medicine Ibn Al Jazzar, University of Sousse, Sousse, Tunisia.
Pan Afr Med J. 2020 Aug 3;36:237. doi: 10.11604/pamj.2020.36.237.19179. eCollection 2020.
Despite obstetric and pediatric progress, twin pregnancy still represents nowadays a high-risk situation for both pregnancy and childbirth. It still remains a distressing situation for the obstetric team. The aim of this study was to describe the practice of twin pregnancy deliveries in the obstetrics and gynecology department of Sousse, the maternal and fetal prognosis and to analyze the factors that may influence it. A descriptive, retrospective study of twin pregnancies births was conducted over a period of two years. We included twin pregnancies that have reached at least 28 weeks of amenorrhea (SA) and women having a twin pregnancy complicated by fetal death in utero. Women with a twin pregnancy who gave birth before 28 weeks were excluded. Bi-chorionic bi-amniotic pregnancies represented 67% of cases, compared with only 11.5% of mono-chorial bi-amniotic pregnancies and 3% of mono-chorial mono-amniotic pregnancies. A total of 52 patients have scheduled caesareans. Spontaneous labor was noticed in 304 cases, and was initiated in 43 cases. A total of 178 women gave birth by vaginal delivery (44.6%) and 215 by cesarean (53.9%). The cesarean rate for the second twin was 1.5%. When the delivery was vaginal, 19 cases of complications were observed (10.7%). We analyzed the Apgar score of both the first and the second twin according to the mode of delivery. There was no statistically significant difference in the Apgar score between the two delivery routes. Perinatal morbidity and mortality is higher for the second twin than for the first twin. Maternal morbidity was higher in vaginal delivery than cesarean delivery. There are no significant differences in the Apgar score according to whether the infants were born by vaginal delivery or by caesarean.
尽管产科和儿科取得了进展，但如今双胎妊娠对于妊娠和分娩来说仍然是一种高危情况。它对产科团队而言依旧是令人苦恼的状况。本研究的目的是描述苏塞妇产科双胎妊娠分娩的实践情况、母婴预后，并分析可能影响其的因素。对双胎妊娠分娩进行了为期两年的描述性回顾性研究。我们纳入了至少停经28周的双胎妊娠以及双胎妊娠合并宫内胎儿死亡的女性。双胎妊娠在28周前分娩的女性被排除。双绒毛膜双羊膜囊妊娠占病例的67%，相比之下，单绒毛膜双羊膜囊妊娠仅占11.5%，单绒毛膜单羊膜囊妊娠占3%。共有52例患者计划进行剖宫产。304例出现自然临产，其中43例临产发动。共有178名女性经阴道分娩（44.6%），215名经剖宫产分娩（53.9%）。第二个胎儿的剖宫产率为1.5%。当分娩为阴道分娩时，观察到19例并发症（10.7%）。我们根据分娩方式分析了第一个和第二个胎儿的阿氏评分。两种分娩途径的阿氏评分在统计学上无显著差异。第二个胎儿的围产期发病率和死亡率高于第一个胎儿。阴道分娩的产妇发病率高于剖宫产分娩。根据婴儿是经阴道分娩还是剖宫产出生，阿氏评分无显著差异。
