Abdominal delivery in the intact amniotic sac in twin pregnancy.

OBJECTIVE

There has been an increasing trend for Caesarean deliveries in twin pregnancies over the last decades; preferred mode of delivery is still unclear. The article presents the mode of twin delivery within intact amniotic sac.

METHODS

The intrapartum courses in 70 matched twin pairs extracted by Caesarean section were analysed. Neonates were distributed to two groups - main (delivered "en caul") and control (delivered by conventional Caesarean section) groups, and subdivided according to gestational age at the time of delivery: 28-30 weeks, 31-33 weeks and 34-37 weeks. Neonates delivered first and second were matched by pairs.

RESULTS

The duration of Caesarean section was higher in the main group (delivered "en caul"). Apgar score at 5-th min depend on the gestational age at birth and was higher in main group. Mechanical ventilation term and length of hospital stay were lower in main group. Postnatal neurological examination showed lower incidence of brain damage in the main group. During the first year of life, neonates extracted within intact amniotic sac showed lower morbidity rate. This was correct also for pairs of neonates matched by delivery order.

CONCLUSIONS

Presented method improves neonates' Apgar score, reduces the need for resuscitation and influence of intrapartum negative factors. The length of hospital stay and hospitalisation rate for the first year of life were also lower in neonates delivered "en caul", providing an economical benefit.