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Related Experiment Videos

The second-born twin: can we improve outcomes?

R P Prins1

  • 1Department of Obstetrics and Gynecology, Manuel Hospital, Portland, OR.

American Journal of Obstetrics and Gynecology
|June 1, 1994
PubMed
Summary

The second-born twin faces higher risks of respiratory issues and complications. Lower birth weight and nonvertex presentation significantly increase these adverse outcomes for the second twin.

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Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Perinatology

Background:

  • Twin gestations present unique challenges for neonatal outcomes.
  • Understanding disparities between first- and second-born twins is crucial for clinical management.

Purpose of the Study:

  • To compare the outcomes of second-born twins with their first-born counterparts.
  • To identify factors contributing to any observed differences in twin outcomes.
  • To inform clinical strategies for improving second-born twin health.

Main Methods:

  • Retrospective review of twin pregnancies (1989-1992).
  • Exclusion of stillborn twins, infants < 500 gm, or those with congenital anomalies.
  • Direct comparison of 200 twin pairs, with the first twin serving as the benchmark.

Main Results:

  • Second-born twins exhibited higher rates of intubation, respiratory distress syndrome, resuscitation, and lower 5-minute Apgar scores.
  • Neonatal deaths and complications were elevated in the second-born twin group, particularly those weighing < 1500 gm.
  • Nonvertex presentation in the second twin increased risks, while cesarean delivery did not mitigate these differences.

Conclusions:

  • Second-born twins face significantly increased risks of adverse outcomes compared to first-born twins.
  • Birth weight and nonvertex presentation are key risk factors for second-born twins.
  • Cesarean section does not equalize outcomes; further prospective research is warranted.

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