We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Download Mobile App




Twins Should Be Delivered at 37 Weeks to Minimize Deaths

By HospiMedica International staff writers
Posted on 22 Sep 2016
Print article
A new study concludes that in order to minimize perinatal deaths, twin pregnancies delivery should be considered at 37 weeks’ gestation, and delivery of identical twins should be considered at 36 weeks.

Researchers at the University of Adelaide (UA; Australia), Queen Mary, University of London (QMUL; United Kingdom), and other institutions participating in the Global Obstetrics Network (GONet) collaboration analyzed the results of 32 studies published within the past 10 years of women with uncomplicated twin pregnancies reporting stillbirth and neonatal mortality rates at various gestational ages after 34 weeks. Overall, the studies included 35,171 twin pregnancies, 29,685 of them dichorionic and 5,486 monochorionic.

The results revealed that in dichorionic twin pregnancies beyond 34 weeks, the prospective weekly risk of stillbirths from expectant management and the risk of neonatal death from delivery were balanced at 37 weeks’ gestation; delay in delivery by one week led to an additional 8.8 perinatal deaths per 1,000 pregnancies. In monochorionic pregnancies beyond 34 weeks, there was a trend towards an increase in stillbirths, with an additional 2.5 per 1,000 perinatal deaths beyond week 36.

The rates of neonatal morbidity showed consistent reduction with increasing gestational age in both monochorionic and dichorionic pregnancies, with admission to the neonatal intensive care unit (nICU) being the commonest neonatal complication. The authors speculated that the actual risk of stillbirth near term might even be higher than reported estimates, but is not realized due to the global policy of planned delivery in twin pregnancies. The study was published on September 6, 2016, in BMJ.

“In women with dichorionic twin pregnancies, delivery should be considered at 37 weeks' gestation to prevent the significant increase in stillbirths associated with expectant management, compared with the risk of neonatal deaths associated with early delivery,” concluded senior author professor of maternal and perinatal health Shakila Thangaratinam, MD, PhD, of QMUL. “In monochorionic twin pregnancies, there is no clear evidence to support routine delivery before 36 weeks' gestation.”

Twin pregnancies are high risk, with a thirteen-fold increase in rates of stillbirth in monochorionic and a fivefold increase in dichorionic twins, when compared to singleton pregnancies. Uncomplicated twin pregnancies are often delivered early in an attempt to prevent late stillbirth, but delivery before term is associated with neonatal prematurity complications. The recent global drive to prevent stillbirth has highlighted multiple pregnancy as a major risk factor in high-income countries, with calls to prioritize evaluation of timing of delivery and outcomes in twin pregnancies.

Related Links:
University of Adelaide
Queen Mary, University of London
Gold Member
12-Channel ECG
CM1200B
Gold Member
Real-Time Diagnostics Onscreen Viewer
GEMweb Live
Silver Member
Compact 14-Day Uninterrupted Holter ECG
NR-314P
New
Silver Member
Mobile X-Ray Barrier
Lead Acrylic Mobile X-Ray Barriers

Print article

Channels

Critical Care

view channel
Image: Researchers have developed a novel risk score for cardiovascular complications after bone marrow transplant (Photo courtesy of 123RF)

Novel Tool Predicts Cardiovascular Risks after Bone Marrow Transplantation

Every year, thousands of people undergo bone marrow transplants to potentially cure serious diseases like leukemia, lymphoma, and immune deficiency disorders. While these transplants can be lifesaving,... Read more

Surgical Techniques

view channel
Image: The Early Bird Bleed Monitoring System provides visual and audible indicators of the onset and progression of bleeding events (Photo courtesy of Saranas)

Novel Technology Monitors and Lowers Bleeding Complications in Patients Undergoing Heart Procedures

Bleeding complications at the femoral access site can significantly hamper recovery, affecting the success of procedures, patient satisfaction, and overall healthcare costs. It is crucial for surgeons... Read more

Health IT

view channel
Image: First ever institution-specific model provides significant performance advantage over current population-derived models (Photo courtesy of Mount Sinai)

Machine Learning Model Improves Mortality Risk Prediction for Cardiac Surgery Patients

Machine learning algorithms have been deployed to create predictive models in various medical fields, with some demonstrating improved outcomes compared to their standard-of-care counterparts.... Read more

Point of Care

view channel
Image: The new eye-safe laser technology can diagnose traumatic brain injury (Photo courtesy of 123RF)

Novel Diagnostic Hand-Held Device Detects Known Biomarkers for Traumatic Brain Injury

The growing need for prompt and efficient diagnosis of traumatic brain injury (TBI), a major cause of mortality globally, has spurred the development of innovative diagnostic technologies.... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.