Outcomes of vertex‐vertex vs. vertex‐breech presentation in twin pregnancy after vaginal delivery in China

Author:

Liu Huahua1,Yan Shuhan2ORCID,Wu Fan2,Bai Ting2,Zhang Feng2ORCID

Affiliation:

1. Affiliated Maternity and Child Health Care Hospital of Nantong University Nantong China

2. Medical College of Nantong University Nantong China

Abstract

AbstractObjectiveTo compare the maternal and neonatal outcomes of twin pregnancies between vertex and nonvertex presentations of the second twin in vaginal delivery.MethodsIn this unicentric retrospective cohort study, we collected data from 213 cases of vaginal twin deliveries from January 2016 to July 2020. Participants were divided into the vertex‐vertex presentation group (VV) and vertex‐breech presentation group (VB). Data on maternal and neonatal outcomes were compared between groups.ResultsAmong the 213 mothers and 426 infants (213 twin pairs), there were 140 women in the VV group and 73 women in the VB group (65.73% vs. 34.27%). Infants in the VB group had a higher incidence of admission to NICU (51.43% vs. 68.49%, p = 0.017), lower 1‐min (11.43% vs. 28.77%, p < 0.001) and 5‐minute Apgar scores (1.43% vs. 4.11%, p = 0.043) for the second twin. However, after the adjustment for sex of the twin, birth weight, chorionicity, and gestational age, the greater risk of admission to NICU and low 5‐min Apgar score was no longer significantly different.ConclusionVB twins are at no greater overall risk of a poor outcome due to breech presentation in the second twin. However, the presentation of the second fetus represents a risk factor for a low 1‐min Apgar score. Obstetricians and midwives should consider appropriate interventions for second twins who present breech versus vertex.

Funder

National Natural Science Foundation of China

Publisher

Wiley

Subject

Obstetrics and Gynecology

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