Impact of birthweight discordance and of non-vertex presentation of the second twin on successful vaginal birth – The Esprit Trial [poster]

Hdl Handle:
http://hdl.handle.net/10147/128779
Title:
Impact of birthweight discordance and of non-vertex presentation of the second twin on successful vaginal birth – The Esprit Trial [poster]
Authors:
Breathnach, F M; Carroll, S.; McAuliffe, A; Geary, M; Daly, S; Higgins, John R.; Dornan, J; Morrisson, J; Burke, G; Higgins, S.; Malone, Fergal D
Affiliation:
Rotunda Hospital
Publisher:
Mosby Inc.
Journal:
American Journal of Obstetrics & Gynecology
Issue Date:
Dec-2009
URI:
http://hdl.handle.net/10147/128779
Additional Links:
http://www.ajog.org/article/S0002-9378(09)01217-4/fulltext
Item Type:
Presentation
Language:
en
Description:
OBJECTIVE: To determine the impact of intratwin birthweight discordance and of non-vertex presentation of the second twin on successful vaginal delivery. STUDY DESIGN: The ESPRIT Trial is a national prospective population study of 642 consecutive twin pregnancies managed and delivered at 8 tertiary referral centers in one country. All pregnancies are followed using a uniform sonographic surveillance protocol. RESULTS: Vaginal or cesarean delivery (CD) was planned for 310 (48%) and 332 (52%) women, respectively. Birthweight discordance of 20% was documented in 12% (37/310) of patients who underwent a trial of labor. The sensitivity of ultrasound within 2 weeks of delivery for detection of this degree of discordance was 86%, specificity 61%. While the overall CD rate was 64% (411/642), intrapartum CD was needed in 29% (90/310) of cases where vaginal delivery was planned. Successful trial of labor did not correlate with advancing gestational age (logistic regression p-value 0.2409), vertex presentation of the 2nd twin (p-value 0.3252), nor with concordant size (regression p-value 0.2988). CONCLUSION: Neither size discordance nor non-vertex presentation of the 2nd twin is predictive of CD. When the larger twin is not presenting, successful vaginal delivery can still be anticipated in most cases.
Keywords:
BIRTHWEIGHT; INFANT

Full metadata record

DC FieldValue Language
dc.contributor.authorBreathnach, F Men
dc.contributor.authorCarroll, S.en
dc.contributor.authorMcAuliffe, Aen
dc.contributor.authorGeary, Men
dc.contributor.authorDaly, Sen
dc.contributor.authorHiggins, John R.en
dc.contributor.authorDornan, Jen
dc.contributor.authorMorrisson, Jen
dc.contributor.authorBurke, Gen
dc.contributor.authorHiggins, S.en
dc.contributor.authorMalone, Fergal Den
dc.date.accessioned2011-04-27T14:58:01Z-
dc.date.available2011-04-27T14:58:01Z-
dc.date.issued2009-12-
dc.identifier.urihttp://hdl.handle.net/10147/128779-
dc.descriptionOBJECTIVE: To determine the impact of intratwin birthweight discordance and of non-vertex presentation of the second twin on successful vaginal delivery. STUDY DESIGN: The ESPRIT Trial is a national prospective population study of 642 consecutive twin pregnancies managed and delivered at 8 tertiary referral centers in one country. All pregnancies are followed using a uniform sonographic surveillance protocol. RESULTS: Vaginal or cesarean delivery (CD) was planned for 310 (48%) and 332 (52%) women, respectively. Birthweight discordance of 20% was documented in 12% (37/310) of patients who underwent a trial of labor. The sensitivity of ultrasound within 2 weeks of delivery for detection of this degree of discordance was 86%, specificity 61%. While the overall CD rate was 64% (411/642), intrapartum CD was needed in 29% (90/310) of cases where vaginal delivery was planned. Successful trial of labor did not correlate with advancing gestational age (logistic regression p-value 0.2409), vertex presentation of the 2nd twin (p-value 0.3252), nor with concordant size (regression p-value 0.2988). CONCLUSION: Neither size discordance nor non-vertex presentation of the 2nd twin is predictive of CD. When the larger twin is not presenting, successful vaginal delivery can still be anticipated in most cases.en
dc.language.isoenen
dc.publisherMosby Inc.en
dc.relation.urlhttp://www.ajog.org/article/S0002-9378(09)01217-4/fulltexten
dc.subjectBIRTHWEIGHTen
dc.subjectINFANTen
dc.titleImpact of birthweight discordance and of non-vertex presentation of the second twin on successful vaginal birth – The Esprit Trial [poster]en
dc.typePresentationen
dc.contributor.departmentRotunda Hospitalen
dc.identifier.journalAmerican Journal of Obstetrics & Gynecologyen
dc.description.provinceLeinster-
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