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[Possibilities in modification of the risk to the child in multiple pregnancy and labor]
A comparison of twin deliveries from 1966 to 1971 (140 = 1,23%) and from 1972 to 1974 (65 = 1,07%) indicates a decrease of the uncorrected perinatal mortality from 10,35% to 6,15% caused by early diagnosis, gestation prolonging measures, diagnosis of placental insufficiency and management of delivery. Concerning the first twin the decrease of perinatal mortality was more evident from 7,86% to 1,54% compared with the second twin from 12,86% to 10,77%. Nevertheless the following statement can be made: up to 1971 perinatal mortality was mainly a problem of prematurely born infants; it is changed now to a problem of antenatal mortality of small for date infants. Prematurely birth and mortality of twins may be well influenced by: 1. Early diagnosis. 2. Widely used hospitalisation, beginning from 28 th week of gestation. 3. Widely used cervix-cerclage and uterotocolysis. 4. Intensive antenatal care. 5. Intranatal intensive care of both infants (cardiotocography, blood gas analysis). 6. Limitation of the interval to 5 to 10 minutes. 7. Widened caesarean section indication (breech presentation, small for date infants).
A comparison of twin deliveries from 1966 to 1971 (140 = 1,23%) and from 1972 to 1974 (65 = 1,07%) indicates a decrease of the uncorrected perinatal mortality from 10,35% to 6,15% caused by early diagnosis, gestation prolonging measures, diagnosis of placental insufficiency and management of delivery. Concerning the first twin the decrease of perinatal mortality was more evident from 7,86% to 1,54% compared with the second twin from 12,86% to 10,77%. Nevertheless the following statement can be made: up to 1971 perinatal mortality was mainly a problem of prematurely born infants; it is changed now to a problem of antenatal mortality of small for date infants. Prematurely birth and mortality of twins may be well influenced by: 1. Early diagnosis. 2. Widely used hospitalisation, beginning from 28 th week of gestation. 3. Widely used cervix-cerclage and uterotocolysis. 4. Intensive antenatal care. 5. Intranatal intensive care of both infants (cardiotocography, blood gas analysis). 6. Limitation of the interval to 5 to 10 minutes. 7. Widened caesarean section indication (breech presentation, small for date infants).