Neonatal Outcomes in Twin Pregnancies

Derince Training and Research Hospital

Status: Completed

Conditions: Twin Pregnancy; Neonate

Treatments: Procedure: General anesthesia; Procedure: Spinal anesthesia

Study type: Observational

Funder types: Other

Identifiers

NCT05104255

2019/05-26

Details and patient eligibility

About

Multiple pregnancies are associated with increased maternal and fetal risks compared to singleton pregnancies. Additionally, the cesarean section rate is quite high in multiple pregnancies. This study aimed to evaluate maternal and fetal characteristics and factors affecting fetal outcomes in twin pregnancies delivered by cesarean section.

Full description

While the frequency of multiple pregnancies varies significantly among societies and individuals, especially in middle and high-income countries, the rate of multiple pregnancies has shown a significant rise worldwide in recent years, with the frequent use of assisted reproductive techniques, which has increased due to an increase in maternal age and a decrease in fertility. As a result, multiple pregnancies constitute approximately 2-4% of all births.

Multiple pregnancies are known to be associated with increased maternal and fetal risks compared to singleton pregnancies. While maternal mortality associated with a twin pregnancy is 2.5 times higher than in singleton pregnancy, adverse neonatal outcomes such as perinatal mortality, fetal growth restriction, and low birth weight are two to three times higher in twins than in singleton newborns. Moreover, neonatal near-miss, which refers to cases that almost resulted in death, is associated with multiple pregnancies.

For all these reasons, the planned cesarean section has been advocated over planned vaginal delivery to reduce the risk of adverse neonatal outcomes (especially for the second-born twin). However, cesarean delivery is known to be associated with a higher risk of maternal morbidity and poor neonatal outcomes. The vast majority of these risks are related to maternal hypotension, prolonged uterine-incision-to-delivery time, and general anesthesia. From this perspective, we aimed to evaluate maternal and fetal characteristics and factors affecting fetal outcomes in twin pregnancies delivered by cesarean section.

Enrollment: 527 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Twin pregnancies
• Parturients delivered by cesarean section

Exclusion criteria

• The triplets or more multiple pregnancies
• Twins delivered through the vaginal route were excluded from the study.

Trial design

527 participants in 1 patient group

Twin neonates

Description:

The demographic data and characteristics of the twins were evaluated.

Treatment:

Procedure: Spinal anesthesia

Procedure: General anesthesia