| Title |
Delivery of the second twin: influence of presentation on neonatal outcome, a case controlled study
|
|---|---|
| Published in |
BMC Pregnancy and Childbirth, May 2018
|
| DOI | 10.1186/s12884-018-1815-0 |
| Pubmed ID | |
| Authors |
Gerhard Bogner, Valentina Wallner, Claudius Fazelnia, Martina Strobl, Birgit Volgger, Thorsten Fischer, Volker R. Jacobs |
| Abstract |
Spontaneous vaginal twin delivery after 32nd week of gestation is safe when first twin presenting cephalic. Aim of this study is to identify obstetric factors influencing the condition of second twin and to verify whether non-cephalic presentation and vaginal breech delivery of the second twin is safe. This is a retrospective case controlled cohort study of 717 uncomplicated twin deliveries ≥32 + 0 weeks of gestation from 2005 to 2014 in two tertiary perinatal centers. Obstetric parameters were evaluated in three groups with descriptive, univariate logistic regression analysis for perinatal outcome of second twins. The three groups included twins delivered by elective cesarean section ECS (n = 277, 38.6%), by unplanned cesarean section UPC (n = 233, 32.5%) and vaginally (n = 207, 28.9%). Serious adverse fetal outcome is rare and we found no differences between the groups. Second twins after ECS had significant better umbilical artery UA pH (p < 0.001) and better Apgar compared to UPC (p = 0.002). Variables for a fetal population "at risk" for adverse neonatal outcome after vaginal delivery (UA pH < 7.20, Apgar 5´ < 9) were associated with higher gestational age (p = 0.001), longer twin-twin interval (p = 0.05) and vacuum extraction of twin A (p = 0.04). Non-cephalic presentation of second twins was not associated (UA pH < 7.20 OR 1.97, CI 95% 0.93-4.22, p = 0.07, Apgar 5´ < 9 OR 1.63, CI 95% 0.70-3.77, p = 0.25, Transfer to neonatal intermediate care unit p = 0.48). Twenty-one second twins (2,9%) were delivered by cesarean section following vaginal delivery of the first twin. Even though non-cephalic presentation was overrepresented in this subgroup, outcome variables were not significantly different compared to cephalic presentation. Even though elective cesarean means reduced stress for second twins this seems not to be clinically relevant. Non-cephalic presentation of the second twin does not significantly influence the perinatal outcome of the second twin but might be a risk factor for vaginal-cesarean birth. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 4 | 57% |
| Unknown | 3 | 43% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 57% |
| Practitioners (doctors, other healthcare professionals) | 2 | 29% |
| Scientists | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 70 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 9 | 13% |
| Other | 8 | 11% |
| Researcher | 7 | 10% |
| Student > Master | 7 | 10% |
| Student > Bachelor | 6 | 9% |
| Other | 15 | 21% |
| Unknown | 18 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 30 | 43% |
| Nursing and Health Professions | 6 | 9% |
| Unspecified | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Business, Management and Accounting | 1 | 1% |
| Other | 5 | 7% |
| Unknown | 24 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 June 2018.
All research outputs
#2,685,042
of 25,064,526 outputs
Outputs from BMC Pregnancy and Childbirth
#724
of 4,672 outputs
Outputs of similar age
#53,641
of 335,632 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#32
of 156 outputs
Altmetric has tracked 25,064,526 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,672 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.3. This one has done well, scoring higher than 84% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 335,632 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 84% of its contemporaries.
We're also able to compare this research output to 156 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 80% of its contemporaries.