Effect of mode of delivery on neonatal outcome of monochorionic diamniotic twin pregnancies: a retrospective cohort study.

OBJECTIVE

To assess whether vaginal delivery increases the risk of adverse neonatal outcome among uneventful monochorionic diamniotic twin pregnancies.

STUDY

DESIGN

We conducted a retrospective controlled cohort study on 112 uneventful monochorionic diamniotic twin pregnancies at > or = 34 weeks' gestation. The outcomes of 52 monochorionic diamniotic twins delivered vaginally were compared with those of 172 monochorionic diamniotic twins delivered by cesarean section.

RESULTS

Five babies (2.9%) in the cesarean section group had a 5-minute Apgar score < 7 and needed orotracheal intubation, whereas in the vaginal delivery group no 5-minute Apgar score < 7 or orotracheal intubation occurred (p = 0.002). Delivery by cesarean section presented higher rates of admission to neonatal intensive care unit (62 out of 172 babies delivered by cesarean section compared to 3 out of 52 babies delivered vaginally, p < 0.001). There were no cases of intrapartum twin-to-twin transfusion syndrome or neonatal death at time of hospital discharge in either group.

CONCLUSION

Vaginal delivery appears to be a good management option in uneventful monochorionic diamniotic twin pregnancies after 34 weeks' gestation.