[Comparative analysis of labor in twin pregnancies in years 1987-91 and 1997-2001]

The aim of the study was to evaluate the course of twin pregnancy deliveries with particular regard to parity, the way of pregnancy termination, indications for cesarean section and sterility treatment.

The studied material consisted of two groups of patients who gave birth to twins in our clinic: the first one of 62 women in years 1997-2001 and the second group of 92 women in years 1987-1991. The average age of patients was 29.4 vs 28.7 respectively.

There were 48.3% of primiparas in the first group, comparing to 44.5% in the second. The average time of pregnancy termination was 35 vs 35.97 Hbd respectively. Premature labours contributed to 80.6% vs 52% of all cases, which was statistically significant (p<0.001). Obstetrical procedures were applied in 6.5% vs 25% of cases respectively (p = 0.003). The indications for cesarean section have changed in regard to the position of the second fetus (when first in cephalic longitudinal lie, second in other than cephalic) and therefore contributed to 78.5% of cases in first and only 12.5% in second group. Thus the application of obstetrical procedures on the second fetus decreased to 18.2% vs 63% (p=0.002). In both groups cesarean sections were most often performed when the position of the first fetus was other than cephalic. In both groups the mediana of Apgar score of the second twin was lower than of the first. But the number of stillborns and general neonatal deaths significantly decreased over the years (0.8% and 2.4% vs 4.9% and 5.36%). Comparing both studied groups, the rate of the twin pregnancy after sterility treatment is rising: 16% vs 7.6%.

The significance of the second twin position as an indication for cesarean delivery has risen over the years, thereby displacing the use of obstetrical procedures in those cases. In spite of earlier pregnancy termination and higher premature labour rate, there is a significant drop in the number of stillborns and neonatal deaths. In the age of infertility treatment, the number of twin pregnancy is rising.