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| Clinical study on the mode of delivery and perinatal outcome of dichorionic diamniotic twin pregnancy |
| Department of Obstetrics，The First Affiliated Hospital of Kunming Medical University, Kunming ,650032 |
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Abstract Objective: To explore the association between the mode of delivery and perinatal outcome in dichorionic diamniotic (DCDA) twin pregnancy. Methods: 162 patients of DCDA from January 2012 to January 2017 in the first affiliated hospital of Kunming medical university were enrolled and divided into two groups according to the mode of delivery, which included vaginal delivery group (50 cases) and cesarean delivery group (112 cases). The perinatal outcome was compared between the two groups. Results: (1)The incidence of pregnant week less than 37 weeks and birth weight less than 2500g in vaginal delivery group was significantly higher than that in cesarean delivery group (P﹤005). The incidence of pregnant week more than or equal to 37 weeks and birth weight more than or equal to 2500g in cesarean delivery group were significantly higher than those in vaginal delivery group (P﹤0.05). (2) The incidence of preeclampsia in cesarean delivery group was significantly higher than that in vaginal delivery group (P﹤0.05). (3) There was no significantly difference in postpartum hemorrhage and neonatal mortality rate between the two groups (P＞0.05).(4) There was no significantly difference in neonatal asphyxia rate of the first fetus between the two groups (P＞0.05), whereas the neonatal asphyxia rate of the second fetus was significantly higher in vaginal delivery group than that in cesarean delivery group (P﹤0.05). There was no significantly difference in neonatal asphyxia rate of the second fetus when delivery interval less than or equal to 15 minutes between the two groups (P＞0.05), whereas the neonatal asphyxia rate of the second fetus when delivery interval over 15 minutes was significantly higher in vaginal delivery group than that in cesarean delivery group (P﹤0.05). The pH and base excess (BE) of the second fetus when delivery interval over 15 minutes was significantly higher in vaginal delivery group than that in delivery interval less than or equal to 15 minutes group (P﹤0.05). Conclusion: To achieve the optimal perinatal outcome, the mode of delivery of DCDA pregnancy with the cephalic presentation of the first fetus should be analyzed according to pregnant weeks, estimated fetal weight and pregnant complications. Meanwhile, the management of the second fetus in the second should be emphasized and the delivery interval should be less than or equal to 15 minutes.
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