Mode of delivery and neonatal outcomes in extremely preterm Vertex/nonVertex twins.

Abstract:

BACKGROUND:One of the controversies in the management of twin gestations relates to mode of delivery, especially when the second twin is in a nonvertex presentation (Vertex/nonVertex pairs) and birth is imminent at extremely low gestation. OBJECTIVE:We hypothesized that, for Vertex/nonVertex twins born before 28 weeks' gestation, cesarean delivery would be associated with a lower risk of adverse neonatal outcomes than trial of vaginal delivery. Our aim was to test this hypothesis by comparing the neonatal outcomes of Vertex/nonVertex twins born before 28 weeks' gestation by mode of delivery using a large national cohort. STUDY DESIGN:This work is a retrospective cohort study of all twin infants born at 240/7 to 276/7 weeks' gestation and admitted to level III neonatal intensive care units participating in the Canadian Neonatal Network (2010-2017). Exposure is defined a trial of vaginal delivery for Vertex/nonVertex twins. Nonexposed (control) groups are defined as cases where both twins were delivered by cesarean delivery, either in vertex or nonvertex presentation (control group 1) or owing to the nonvertex presentation of the first twin (control group 2). Outcome measures are defined as a composite of neonatal death, severe neurologic injury, or birth trauma. RESULTS:A total of 1082 twin infants (541 twin pairs) met the inclusion criteria: 220 Vertex/nonVertex pairs, of which 112 had a trial of vaginal delivery (study group) and 108 had cesarean delivery for both twins (control group 1); 170 pairs with the first twin in nonvertex presentation, all of which were born by cesarean delivery (control group 2); and 151 pairs with both twins in vertex presentation (vertex or nonvertex). In the study group, the rate of urgent cesarean delivery for the second twin was 30%. The rate of the primary outcome in the study group was 42%, which was not significantly different compared with control group 1 (37%; adjusted relative risk, 0.93; 95% confidence interval, 0.71-1.22) or control group 2 (34%; adjusted relative risk, 1.20; 95% confidence interval, 0.92-1.58). The findings remained similar when outcomes were analyzed separately for the first and second twins. CONCLUSION:For preterm Vertex/nonVertex twins born at <28 weeks' gestation, we found no difference in the risk of adverse neonatal outcome between a trial of vaginal delivery and primary cesarean delivery. However, a trial of vaginal delivery was associated with a high rate of urgent cesarean delivery for the second twin.

journal_name

Am J Obstet Gynecol

authors

Hiersch L,Shah PS,Khurshid F,Masse E,Murphy K,McDonald SD,Carson G,Barrett J,Melamed N,Canadian Neonatal Network Investigators and the Canadian Preterm Birth Network Investigators.

doi

10.1016/j.ajog.2020.12.002

subject

Has Abstract

pub_date

2020-12-09 00:00:00

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(20)31368-5

pub_type

杂志文章
  • The resolution of chronic pelvic pain after normal laparoscopy findings.

    abstract::Sixty patients with chronic pelvic pain were monitored after diagnostic laparoscopy had excluded obvious pelvic pathology. Six months after the procedure only two patients described their symptoms as unchanged or worse. Treatment should be limited to the minority of patients whose symptoms remain 6 months after laparo...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(92)91343-9

    authors: Baker PN,Symonds EM

    更新日期:1992-03-01 00:00:00

  • Neuromodulatory regulation of gonadotropin-releasing hormone pulsatile discharge in women.

    abstract::The pulsatile release of gonadotropin-releasing hormone and the consequent secretion of gonadotropins are regulated by a complex interplay of steroids, neuropeptides, catecholamines, and environmental factors. Estrogen and progesterone influence the amplitude and frequency of luteinizing hormone pulsatile secretion. T...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1016/0002-9378(90)91436-g

    authors: Jaffe RB,Plosker S,Marshall L,Martin MC

    更新日期:1990-11-01 00:00:00

  • The outcome of triplet, quadruplet, and quintuplet pregnancies managed in a perinatal unit: obstetric, neonatal, and follow-up data.

    abstract::Multifetal gestation is associated with increased frequency of maternal complications and higher perinatal morbidity and mortality. The need for contemporary data on the outcome of multifetal gestations is further underscored when selective reduction is considered. The present study details the obstetric management, n...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(90)90407-x

    authors: Gonen R,Heyman E,Asztalos EV,Ohlsson A,Pitson LC,Shennan AT,Milligan JE

    更新日期:1990-02-01 00:00:00

  • Extracellular and intracellular magnesium depletion in pregnancy and gestational diabetes.

    abstract:OBJECTIVE:Our purpose was to investigate a possible ionic basis linking pregnancy and gestational diabetes with the vascular disorders associated with them. STUDY DESIGN:We used phosphorus 31 nuclear magnetic resonance spectroscopy and magnesium- and calcium-specific ion electrodes to measure erythrocyte intracellular...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(95)90035-7

    authors: Bardicef M,Bardicef O,Sorokin Y,Altura BM,Altura BT,Cotton DB,Resnick LM

    更新日期:1995-03-01 00:00:00

  • Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse.

    abstract:OBJECTIVE:The purpose of this study was to describe patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse symptoms and to describe predictors of preference for uterine preservation. STUDY DESIGN:This multicenter, cross-sectional study evaluated patient preferences for uterin...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.ajog.2013.08.003

    authors: Korbly NB,Kassis NC,Good MM,Richardson ML,Book NM,Yip S,Saguan D,Gross C,Evans J,Lopes VV,Harvie HS,Sung VW

    更新日期:2013-11-01 00:00:00

  • A simple assessment of the risk of low birth weight to select women for nutritional intervention.

    abstract::There is growing evidence that the high prevalence of low-birth-weight (LBW) babies, a characteristic of many poor societies, can be significantly reduced through nutritional intervention programs. In order to increase the efficiency of these programs, pregnant women at risk of delivering LBW babies must be identified...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(76)90886-3

    authors: Lechtig A,Delgado H,Yarbrough C,Habicht JP,Martorell R,Klein RE

    更新日期:1976-05-01 00:00:00

  • Inner thigh taping vs traction for cervical ripening with a Foley catheter: a randomized controlled trial.

    abstract:OBJECTIVE:To assess the effectiveness of inner thigh "Taping" compared with "Traction" using a weighted bag when an intracervical Foley catheter is used for cervical ripening. STUDY DESIGN:We performed a randomized controlled trial at a tertiary hospital on women with a singleton pregnancy in cephalic presentation adm...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ajog.2013.05.028

    authors: Gibson KS,Mercer BM,Louis JM

    更新日期:2013-09-01 00:00:00

  • Challenging the 4- to 5-minute rule: from perimortem cesarean to resuscitative hysterotomy.

    abstract::Although perimortem delivery has been recorded in the medical literature for millennia, the procedural intent has evolved to the current fetocentric approach, predicating timing of delivery following maternal cardiopulmonary arrest to optimize neonatal outcome. We suggest a call to action to reinforce the concept that...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1016/j.ajog.2015.07.019

    authors: Rose CH,Faksh A,Traynor KD,Cabrera D,Arendt KW,Brost BC

    更新日期:2015-11-01 00:00:00

  • Contemporary labor patterns: the impact of maternal body mass index.

    abstract:OBJECTIVE:We sought to compare labor patterns by body mass index (BMI). STUDY DESIGN:A total of 118,978 gravidas with a singleton term cephalic gestation were studied. Repeated-measures analysis constructed mean labor curves by parity and BMI categories for those who reached 10 cm. Interval-censored regression analysi...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.ajog.2011.06.014

    authors: Kominiarek MA,Zhang J,Vanveldhuisen P,Troendle J,Beaver J,Hibbard JU

    更新日期:2011-09-01 00:00:00

  • Failure of ibuprofen in treatment of herpes genitalis.

    abstract::Motrin (ibuprofen), a potent inhibitor of prostaglandin synthetase, was tested in women and men for treatment of recurrences of genital herpes. In a double-blind trial, no statistically significant differences were observed between treated and placebo groups in any of the measured parameters. ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 临床试验,杂志文章

    doi:10.1016/0002-9378(86)90842-2

    authors: Milch PO,Monheit AG,Rochelson BL,Metz G,Baker DA

    更新日期:1986-08-01 00:00:00

  • Neurological control of fetal heart rate in 20 cases of anencephalic fetuses.

    abstract::Fetal heart rate (FHR) is influenced by the central nervous system, cardiac automatism, biochemical factors, etc. Changes in FHR were correlated with the anatomic defect in autopsy material from 20 anencephalic infants, and, on this basis, the following hypotheses were formed, subject to later experimental proof. (1) ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(84)90199-6

    authors: Terao T,Kawashima Y,Noto H,Inamoto Y,Lin TY,Sumimoto K,Maeda M

    更新日期:1984-05-15 00:00:00

  • Early physiologic squamous metaplasia of the cervix: light and electron microscopic observations.

    abstract::A light and electron microscopic study was undertaken of the early phases of cervical squamous metaplasia. A study of areas of columnar epithelium with one row of subcolumnar cells revealed a spectrum of squamous differentiation ranging from cytologically undifferentiation to more characteristically basal type squamou...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0002-9378(15)33239-7

    authors: Lawrence WD,Shingleton HM

    更新日期:1980-07-15 00:00:00

  • A randomized, prospective study comparing once-daily gentamicin versus thrice-daily gentamicin in the treatment of puerperal infection.

    abstract:OBJECTIVE:The efficacy, safety, and antibiotic-related charges for once-daily gentamicin with twice-daily clindamycin were compared with those of thrice-daily dosing of these antibiotics. STUDY DESIGN:Patients with puerperal endometritis or with chorioamnionitis in labor assessed to be at risk for endometritis were ra...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0002-9378(97)70269-2

    authors: Mitra AG,Whitten MK,Laurent SL,Anderson WE

    更新日期:1997-10-01 00:00:00

  • Stromal invasion in endometrial adenocarcinoma.

    abstract::The ability to predict myometrial invasion by endometrial adenocarcinoma is useful for preoperative treatment purposes. The presence of stromal invasion is one possible method of predicting myometrial invasion, but criteria for the presence of stromal invasion have been lacking. Recently, criteria for its detection we...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(84)90283-7

    authors: King A,Seraj IM,Wagner RJ

    更新日期:1984-05-01 00:00:00

  • Content of amniotic fluid prostaglandins in normal, diabetic, and drug-abuse human pregnancy.

    abstract::This study attempts quantification of prostaglandins (PGs) in amniotic fluid antepartum at 24, 26-33, 34-36 weeks of gestation and in labor in 6 normal patients, 6 diabetic patients, 3 patients taking methadone, and 1 patient taking heroin. Results of measurements of PGs showed that in the different weeks of gestatio...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0002-9378(16)33793-0

    authors: Singh EJ,Zuspan FP

    更新日期:1974-02-01 00:00:00

  • Mechanical ventilation in an obstetric population: characteristics and delivery rates.

    abstract:OBJECTIVE:The purpose of this study was to describe the characteristics and outcomes of obstetric patients who require mechanical ventilation. STUDY DESIGN:A review was conducted of obstetric patients who required mechanical ventilation and who received care at our institutions between 1990 and 1998. Data that were co...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1067/mob.2003.68

    authors: Jenkins TM,Troiano NH,Graves CR,Baird SM,Boehm FH

    更新日期:2003-02-01 00:00:00

  • Evidence-based surgery for cesarean delivery.

    abstract:OBJECTIVE:The purpose of this study was to provide evidenced-based guidance for surgical decisions during cesarean delivery. STUDY DESIGN:We performed MEDLINE, PubMed, EMBASE, and COCHRANE searches with the terms cesarean section, cesarean delivery, cesarean, pregnancy, randomized trials, and each technical aspect of ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1016/j.ajog.2005.03.063

    authors: Berghella V,Baxter JK,Chauhan SP

    更新日期:2005-11-01 00:00:00

  • Developmental regulation of the expression of 72 and 92 kd type IV collagenases in human trophoblasts: a possible mechanism for control of trophoblast invasion.

    abstract:OBJECTIVE:During early pregnancy fetal cytotrophoblast cells invade the uterus and penetrate the basement membrane, a property that is characteristic of malignant cells. However, unlike tumor invasion, trophoblast invasion of the uterus is under strict control. This control limits invasion, so that it primarily remains...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(94)90107-4

    authors: Shimonovitz S,Hurwitz A,Dushnik M,Anteby E,Geva-Eldar T,Yagel S

    更新日期:1994-09-01 00:00:00

  • Hormone treatment of endometriosis: the estrogen threshold hypothesis.

    abstract::In women with recurrent pelvic pain caused by endometriosis, hormonal therapy with a gonadotropin-releasing hormone agonist is an effective alternative to surgical therapy. The basis for medical treatment of endometriosis is that endometriosis lesions are dependent on estradiol for continued growth. Further, end organ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1016/0002-9378(92)91706-g

    authors: Barbieri RL

    更新日期:1992-02-01 00:00:00

  • Transplacental passage of influenza A/Bangkok (H3N2) mimicking amniotic fluid infection syndrome.

    abstract::Influenza virus infection complicating pregnancy remains a matter of concern because of the frequency of these infections and possible associated increased maternal and perinatal risks. Influenza A/Bangkok (H3N2) infection occurred in a gravid woman in association with fever, chills, and uterine tenderness and contrac...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(84)90604-5

    authors: McGregor JA,Burns JC,Levin MJ,Burlington B,Meiklejohn G

    更新日期:1984-08-15 00:00:00

  • The use of senna with docusate for postoperative constipation after pelvic reconstructive surgery: a randomized, double-blind, placebo-controlled trial.

    abstract:OBJECTIVE:The objective of the study was to compare time to first bowel movement (BM) after surgery in subjects randomized to placebo or senna with docusate. STUDY DESIGN:Ninety-six subjects completed a baseline 7-day bowel diary before and after surgery. After pelvic reconstructive surgery, the subjects were randomiz...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ajog.2010.01.003

    authors: Patel M,Schimpf MO,O'Sullivan DM,LaSala CA

    更新日期:2010-05-01 00:00:00

  • Where is the "W"oman in MCH?

    abstract::Scientific evidence indicates that improving a woman's health before pregnancy will improve pregnancy outcomes. However, for many years, our efforts have focused primarily on prenatal care and on caring for infants after birth. The concept of preconception care has been identified repeatedly as a priority for improvin...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/j.ajog.2008.08.059

    authors: Atrash H,Jack BW,Johnson K,Coonrod DV,Moos MK,Stubblefield PG,Cefalo R,Damus K,Reddy UM

    更新日期:2008-12-01 00:00:00

  • Antepartum fetal testing. I. The oxytocin challenge test.

    abstract::Two hundred seventy-eight high-risk patients were managed by a comprehensive assessment of the anatomic, biochemical, and functional environment of the fetoplacental unit utilizing predetermined guidelines. Decisions to terminate pregnancy were reserved for patients who demonstrated a positive OCT. Perinatal outcome i...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(79)90835-4

    authors: Barrada MI,Edwards LE,Hakanson EY

    更新日期:1979-07-01 00:00:00

  • Can ultrasonography replace amniocentesis in fetal gender determination during the early second trimester?

    abstract::Fetal gender was prospectively determined by ultrasonography in 115 patients with singleton pregnancies between 16 and 20 weeks of gestation. Gender determination was performed as a part of the sonographic examination preceding genetic amniocentesis, and the results were compared to the amniotic fluid fetal karyotype ...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(87)90055-x

    authors: Reece EA,Winn HN,Wan M,Burdine C,Green J,Hobbins JC

    更新日期:1987-03-01 00:00:00

  • Ritodrine infusion during late pregnancy: effects on fetal and placental blood flow, prostacyclin, and thromboxane.

    abstract::To study the effects of ritodrine on fetal and placental blood flow and maternal prostacyclin and thromboxane A2, 14 women with premature uterine contractions between the thirty-first and thirty-sixth weeks of pregnancy were treated with intravenous infusions of ritodrine, with incremental doses up to 200 micrograms p...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(85)90374-6

    authors: Jouppila P,Kirkinen P,Koivula A,Ylikorkala O

    更新日期:1985-04-15 00:00:00

  • Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: the PROMOTE study.

    abstract:OBJECTIVE:The purpose of this study was to evaluate the efficacy of osteopathic manipulative treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and to improve selected outcomes of labor and delivery. STUDY DESIGN:Pregnancy research on osteopathic manipulation optimi...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ajog.2014.07.043

    authors: Hensel KL,Buchanan S,Brown SK,Rodriguez M,Cruser dA

    更新日期:2015-01-01 00:00:00

  • Influence of ionizing radiation on fetoplacental growth in mice.

    abstract::The effects of single doses of 60Co whole-body irradiation were studied in about 600 inbred primiparous Swiss-Webster mice on gestational day 9, 10, 11, or 12. The embryos and their placentas were weighted from day 13 to 18. A reference model surveyed the response of the conceptus to varying doses. A significant reduc...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(75)90889-3

    authors: Philippe JV

    更新日期:1975-11-15 00:00:00

  • The fetal cardiovascular response to increased placental vascular impedance to flow determined with 4-dimensional ultrasound using spatiotemporal image correlation and virtual organ computer-aided analysis.

    abstract:OBJECTIVE:We sought to determine if increased placental vascular impedance to flow is associated with changes in fetal cardiac function using spatiotemporal image correlation and virtual organ computer-aided analysis. STUDY DESIGN:A cross-sectional study was performed in fetuses with umbilical artery pulsatility index...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/j.ajog.2012.11.043

    authors: Hamill N,Romero R,Hassan S,Lee W,Myers SA,Mittal P,Kusanovic JP,Balasubramaniam M,Chaiworapongsa T,Vaisbuch E,Espinoza J,Gotsch F,Goncalves LF,Mazaki-Tovi S,Erez O,Hernandez-Andrade E,Yeo L

    更新日期:2013-02-01 00:00:00

  • Functional significance of the zonal morphologic differences in the normal human placenta. A morphometric study.

    abstract::Previous investigations have shown that the human placenta is a complex organ with different zones, each with a unique morphology. These zonal morphologic difference have been related to a probable blood PO2 gradient operating in the intervillous space. This study describes zonal variations in the vertical plane of th...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(78)90007-8

    authors: Teasdale F

    更新日期:1978-04-01 00:00:00

  • Estrogen and endometrial cancer: cases and two control groups from North Carolina.

    abstract::The relationship between exogenous estrogen and risk of endometrial carcinoma was investigated in 256 women with pathologically confirmed cases, 224 gynecology controls, and 321 community controls. Sources of data included personal interviews, physicians' records, and hospital records; diagnoses were verified by 2 ou...

    journal_title:American journal of obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0002-9378(80)90391-9

    authors: Hulka BS,Fowler WC Jr,Kaufman DG,Grimson RC,Greenberg BG,Hogue CJ,Berger GS,Pulliam CC

    更新日期:1980-05-01 00:00:00