We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Second twin outcome at birth: retrospective analysis in a single tertiary centre in Malaysia.
- Authors
Rahman, Rahana Abd; Mohammed Nawi, Azmawati; Ishak, Shareena; Balaraman, Kartik; Abu, Mohamad Azrai; Abd Azman, Siti Hajar; Kalok, Aida Hani; Mohamed Ismail, Nor Azlin; Mahdy, Zaleha Abdullah; Ahmad, Shuhaila
- Abstract
To investigate factors associated with outcome of second twin during labour. The study was a retrospective cohort study in a single tertiary centre in Malaysia from 2014 until 2018 involving all twin pregnancies delivered at or more than 24 weeks of gestation. Total of 409 twin pregnancies were included. Dichorionic twin comprises of 54.5 % (n=223) and 45.5 % (n=186) are monochorionic. Women with dichorionic pregnancies are significantly older (p<0.001), have more pre-existing medical disorders (p=0.011) and fetal structural anomalies (p=0.009). Monochorionic pregnancies are significantly more amongst Malay (p=0.01) and conceived spontaneously (p<0.001). There are significantly more fetuses both in cephalic presentation (p=0.026), birthweight discrepancy more than 20 % (p=0.038) and shorter mean inter-twin delivery duration (p=0.048) in monochorionic pregnancies. Second twin delivered with Apgar score <7 is significantly more in dichorionic pregnancies (p=0.006). The second twin is associated with lower birthweight, small for gestational age and arterial cord pH<7.25. Within the group of women who delivered both fetuses vaginally, there was significantly more second twins with intertwin delivery duration less than 30 min who were delivered vaginally without instrumentation (p=0.018). There was significantly more second twin with intertwin delivery duration of 30 min and more with arterial cord pH<7.25 (p=0.045). Those who delivered spontaneously had inter-twin delivery duration within 15–29 min. The outcome of second twin is not influenced by type of twin, gestational age at delivery, inter-twin delivery duration, mode of delivery and presentation at birth. The neonatal outcome for the second twin at birth is not influenced by type of twin, gestational age at delivery, inter-twin delivery duration, mode of delivery and presentation at birth in a cohort managed with non-active management of the second twin in Malaysia.
- Subjects
MALAYSIA; RISK assessment; ACADEMIC medical centers; DELIVERY (Obstetrics); VAGINA; MULTIPLE pregnancy; PREGNANCY outcomes; TERTIARY care; DESCRIPTIVE statistics; RETROSPECTIVE studies; LABOR (Obstetrics); PERINATAL death; LONGITUDINAL method; GESTATIONAL age; PREGNANCY complications; BIRTH weight; ASPHYXIA neonatorum; DISEASE risk factors
- Publication
Journal of Perinatal Medicine, 2024, Vol 52, Issue 4, p385
- ISSN
0300-5577
- Publication type
Article
- DOI
10.1515/jpm-2023-0449