Risk factors for emergency cesarean delivery of the second twin after vaginal delivery of the first twin

J Obstet Gynaecol Res. 2009 Jun;35(3):467-71. doi: 10.1111/j.1447-0756.2008.00976.x.

Abstract

Aim: A case-control study of twins was performed to identify clinical predictions of emergency cesarean delivery in the second-born twin after vaginal delivery of the first twin.

Methods: The obstetric records were reviewed of all twin vaginal deliveries at the Japanese Red Cross Katsushika Maternity Hospital from 2002 through 2007.

Results: There were 206 vaginal deliveries of first twins at >or=33 weeks of gestation. Of these deliveries, nine women (4.4%) underwent an emergency cesarean for the delivery of the second twin. The incidence of cesarean delivery for the second twin was significantly greater in cases with a history of infertility therapy (odds ratio: 5.0, 95% confidence intervals: 1.2-22), gestational age at >or=39 weeks (24, 4.7-120), nonvertex presentation (6.2, 1.5-26), operative delivery of the first twin (6.1, 1.5-24) and intertwin delivery time interval >30 min (7.2, 1.7-30).

Conclusion: The most important risk factor of emergency cesarean delivery in the second twin was a gestational age of >or=39 weeks.

MeSH terms

  • Adult
  • Asphyxia Neonatorum
  • Birth Order
  • Case-Control Studies
  • Cesarean Section / statistics & numerical data*
  • Delivery, Obstetric / statistics & numerical data*
  • Diseases in Twins / surgery*
  • Emergencies
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Labor Presentation
  • Pregnancy
  • Pregnancy, Multiple*
  • Reproductive Techniques
  • Risk Factors
  • Twins*