•The Impact of Mode of Delivery On Maternal and Perinatal Outcome In Vertex / Breech Presentation In The Leading Twin

Abstract

Objective

To compare the impact of mode of delivery on maternal and perinatal outcome in   vertex/ breech presentation of leading twin.

Study design

Cross sectional study.

Place & Duration of study

Fatima Hospital, Baqai Medical University Karachi, from July 2018 to  December 2019.

Methodology•

All the twin deliveries were taken into account. They were assigned into two groups A and B. Group A comprised of patients in whom leading twin had vertex and group B of patients in whom leading twin had breech presentation. Maternal and perinatal outcome were compared. Data was analysed using SPSS 20.

Results

There were 78 twin deliveries which constituted 2.12% of the total deliveries. Group A comprised of 42 cases and vaginal birth was contemplated in all. Group B comprised of 36 cases, of whom 24 (66.66%) had successful vaginal births while cesarean section was done in 12 (33.33%). In twin 2 of group B apgar score <7 at 5 min was more frequent in second twin. Other neonatal outcome measures including apgar score at 5 min, still birth, perinatal mortality, admission to NICU, birth trauma, neonatal asphyxia, respiratory distress syndrome, neonatal jaundice, and neurological deficit were not different markedly between the two groups. Maternal morbidity were common between the groups. There was one maternal death reported in group B.

Conclusion

Vaginal birth in twin gestations with leading twin as breech did not worsen the maternal and perinatal outcome in our study.

Key words

Twin, Breech delivery, Maternal outcome, Perinatal outcome.