Does mode of delivery of second twin influence the neonatal outcome

Background: The incidence of twin pregnancies account is about 3% of all gestations. considered at higher risk of severe morbidity and mortality because of obstetric complications. consensus that vaginal delivery for twin is typically indicated for breech increased risk of perinatal mortality and morbidity of study was to examine the association between mode of delivery and NICU admission, neonatal mortality in term and preterm twin pregnancies, particularly for second born twins. delivery of the second of the twins on the neo natal outcome of the second twin. cases of twin pregnancies delivered in hospitals attached to JJM Medical 2014) where the first twin was vertex and delivered vaginally. Pregnancies with ante excluded. Three groups of twin pairs were selected and included in the study. Group A: Twin pairs with the second twin delive red by caesarean section. Group B: Vaginally delivered second twin. Group C: Version and breech extracted second twin. Twin pairs were excluded if the mother was assigned a diagnosis suggesting any ante congenital malformations, immunizat or fever, ante-part um bleeding or placenta praevia syndrome, or intrauterine fetal death. delivered vaginally. Out of 50 cases, 62% had a non admitted into NICU with 24% mortality. All cases of IPV and breech delivery w mortality where as only 52.63% of babies delivered by caesarean sections were admitted i mortality. The neonatal outcome in the three study groups were shown in Table 1 and 2. Second born twins in Group A (second twin delivered by caesarean section) was at lower risk of NICU admission compared to second born twins in group B (vaginally delivered second twin) and group C second twin). Conclusion: Neonatal mortality is lower for the second twin after caesarean delivery compared to Vaginal and IPV-breech but it is not statistically significant. The present results support that, caesarean delivery may be associated with a better chance of neona The incidence of twin pregnancies account is about 3% of all gestations. The second twin is generally considered at higher risk of severe morbidity and mortality because of obstetric complications. consensus that vaginal delivery for twin s is safe when both are in vertex presentation, whereas planned caesarean section is typically indicated for breech presentation of the first twin. Planned vaginal delivery has been associated with an increased risk of perinatal mortality and morbidity of the second twin compared with the first twin. study was to examine the association between mode of delivery and NICU admission, neonatal mortality in term and preterm twin pregnancies, particularly for second born twins. Objectives: To study the influence of various methods of delivery of the second of the twins on the neo natal outcome of the second twin. Material a nd Methods cases of twin pregnancies delivered in hospitals attached to JJM Medical College, Davangere (fro 2014) where the first twin was vertex and delivered vaginally. Pregnancies with ante - Three groups of twin pairs were selected and included in the study. Group A: Twin pairs with the second twin red by caesarean section. Group B: Vaginally delivered second twin. Group C: Version and breech extracted second twin. Twin pairs were excluded if the mother was assigned a diagnosis suggesting any ante congenital malformations, immunizat ion or hydrops, intrauterine growth restriction, chorioamnioniti um bleeding or placenta praevia , preeclampsia or eclampsia, diabetes syndrome, or intrauterine fetal death. Results : Total number of 50 cases were studied where the first twin was vertex and Out of 50 cases, 62% had a non -vertex second twin. 64% of babies delivered vaginally were admitted into NICU with 24% mortality. All cases of IPV and breech delivery w ere admitted into NICU with 50% mortality where as only 52.63% of babies delivered by caesarean sections were admitted i The neonatal outcome in the three study groups were shown in Table 1 and 2. Second born twins in Group A (second twin delivered by caesarean section) was at lower risk of NICU admission (p=0.109) or neonatal death (p=0.232) compared to second born twins in group B (vaginally delivered second twin) and group C (version and breech extracted Neonatal mortality is lower for the second twin after caesarean delivery compared to Vaginal breech but it is not statistically significant. The present results support that, caesarean delivery may be associated with a better chance of neona tal survival in otherwise uncomplicated twin pregnancies. Twin pregnancy, Vaginal delivery, Caesarean section, Internal Podalic version, NICU admission.