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Periventricular leukomalacia and mode of delivery in twins under 1500 g
L J Salomon1, M Duyme, A Rousseau
1Service de Gynécologie-Obstérique, Centre Hospitalier Intercommunal de Poissy-St Germain, Poissy, France.
Background:
The optimal mode of delivery in twin gestations remains undefined, particularly for twins weighing less than 1500 g.
Objective:
To evaluate the impact of the mode of delivery on neonatal outcome in twins below 1500 g.
Materials And Methods:
In this multicenter cohort study during 1999, 66 sets of twins born in hospital and weighing below 1500 g formed our study group. Antenatal and neonatal parameters and their relationship to mode of delivery were studied, based on a factor analysis. Analysis of covariance was used to assess the effect of the mode of delivery on postnatal factors, with antenatal parameters used as covariates.
Results:
Statistical analysis showed that infants delivered vaginally had significantly more periventricular leukomalacia than those children delivered by Cesarean section (p = 0.03). The estimated odds for leukomalacia were higher in the vaginal than in the Cesarean group when adjusted for covariates (OR = 4.7; 95% CI = 1.0, 25.15).
Conclusion:
Routine Cesarean section should be recommended in twin gestations with infants weighing less than 1500 g, regardless of gestational age or fetal presentation.