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Korean Journal of Obstetrics & Gynecology 2006;49(12):2512-2518.
Published online December 1, 2006.
The perinatal outcome of vaginal delivery in twin pregnancy.
Jung Hye Yun, Eun Jung Seo, Hye Young Oh, Ah Rong Byun, Hyun Lee Lee, Sun Pyo Lee, Suk Young Kim
Department of Obstetrics and Gynecology, Graduate School of Medicine Gachon University of Medicine and Science, Incheon, Korea. ksyob@gilhospital.com
Abstract
OBJECTIVE
To evaluate the perinatal outcome of vaginal delivery in twin pregnancy according to the presentation of the fetus. METHODS: A total of 274 cases suitable to this objective were selected from the 301 cases of twin pregnancy delivered between March 2000 and February 2005. They were categorized into 3 groups according to the presentation of the fetus; vertex/vertex as the group A (133 cases), vertex/nonvertex as the group B (80 cases), nonvertex in the first twin as the group C (61 cases). And then each group also was divided into 2 subgroups according to the mode of delivery; vaginal delivery and cesarean delivery. The difference between the subgroups in each group as to perinatal outcome was retrospectively compared and analyzed for statistical significance. RESULTS: The incidence of vaginal delivery in group A (46/133, 34.6%) was significantly higher than in group B (5/80, 6.3%) and C (5/61, 8.2%). A total of 218 (79.6%) cases were underwent the cesarean delivery and the most common indication of cesarean delivery was elective twin cesarean delivery in all 3 groups (65.4%, 93.8%, 91.8% respectively). The incidence of neonatal admission to the neonatal intensive care unit was, however, higher in vaginal delivery (40.2%) than in cesarean delivery (32.8%) in group A. The most common cause for neonatal intensive care unit admission was low birth weight for simple observation, and average admission dates of vaginal delivery was 17.0 days and cesarean delivery was 16.8 days. CONCLUSION: Vaginal delivery of twins depends on the presentation of the fetus, but no significant difference in perinatal outcome of group A were observed between the mode of delivery. Therefore attempt to decrease the incidence of elective twin cesarean delivery in group A is demanded.
Key Words: Twin pregnancy, Vaginal delivery, Perinatal outcome


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