Optimizing outcome of twins by routine cesarean section beyond 37 weeks
Yaniv Zipori1, Tatiana Smolkin, Imad R Makhoul
1Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel. y_zipori@rambam.health.gov.il
American Journal of Perinatology
|July 8, 2010
Summary
Elective cesarean delivery for twins after 37 weeks gestation is recommended. This approach minimizes neonatal respiratory morbidity and reduces maternal complications compared to emergency cesarean birth.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Maternal-Fetal Medicine
Background:
- Optimal timing and mode of twin delivery remain debated.
- Neonatal respiratory morbidity (NRM) and maternal complications are key concerns.
Purpose of the Study:
- To evaluate the impact of gestational age and elective delivery mode on NRM and maternal morbidity in twins.
- To identify risk factors for NRM in twin pregnancies.
Main Methods:
- Retrospective analysis of 711 twin pregnancies (1422 neonates) delivered after 35 weeks' gestation.
- NRM defined as respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN).
- Maternal complications associated with different delivery modes were assessed.
Main Results:
- 74 (5.2%) neonates experienced NRM.
- Risk factors for NRM included maternal age > 25, earlier gestational age, and emergency cesarean section.
- Emergency cesarean delivery was linked to longer hospitalization and increased need for postoperative antibiotics.
Conclusions:
- NRM risk is low for twins born after 37 weeks' gestation.
- Elective cesarean delivery at 37 weeks is suggested to balance NRM and maternal morbidity.
- Elective cesarean delivery offers reduced maternal morbidity compared to emergency cesarean birth.
