Features | Partner Sites | Information | LinkXpress
Sign In
SCHILLER AG
FLUKE BIOMEDICAL
Advantech Europe

Cesarean Section No Safer for Twins Delivery

By HospiMedica International staff writers
Posted on 25 Feb 2013
A new study concludes that planned cesarean section (SC) delivery is no better than with planned vaginal birth (VB) for twins, when the first baby is in a good position.

Researchers at Sunnybrook Health Sciences Centre (Toronto, Canada) and other institutions conducted a trial involving 2,804 women from 26 countries randomized to planned induced VB or planned CS of twins at 32-38 weeks' gestation; only those with the first twin situated head first, and both weighing 1,500–4,000 gram by ultrasound within a week of randomization were included. Centers had to have emergency cesarean available and participating practitioners had to be vouched as skilled at vaginal twin delivery. The primary composite endpoint was perinatal or neonatal mortality or serious neonatal morbidity.

The results showed that death or serious neonatal morbidity occurred in 2% of cases, irrespective of how the birth was planned. The second twin to be delivered had a poorer outcome than the first, but there was no interaction with treatment group. The planned CS group had some crossover to VB (9%), while 40% of the planned VB ended up as CS delivery for both twins, and 4% got vaginal delivery of one and cesarean for the other. None of the components showed a significant difference, but there tended to be more bone fractures in the planned VB group. The study was presented at the Society for Maternal-Fetal Medicine (SMFM) annual meeting, held during February 2013 in San Francisco (CA, USA).

“Skill at operational vaginal birth is considered a fading art, as many of the newer generation of obstetricians haven't been trained in it, but vaginal twin delivery is still common enough a skill that it shouldn't be a barrier to applicability of the results in the community,” concluded lead author Jon Barrett, MBBch, MD, and colleagues. “The data I think will preserve the art and skill of operative vaginal delivery and will serve all of us as a warning lesson that before we trend to what is seemingly an easier and safer option, cesarean section, we should think twice.”

Related Links:

Sunnybrook Health Sciences Center



Channels

Critical Care

view channel
Image: Scanning electron micrograph of a human neutrophil ingesting MRSA (Photo courtesy [US] National Institutes of Health (NIH)/Wikipedia commons).

Common Biocide Promotes Bacteria in Nasal Passages

Triclosan, an antimicrobial agent found in common household soaps, shampoos, and toothpastes promotes the colonization of Staphylococcus aureus in noses, according to a new study. Researchers at the... Read more

Surgical Techniques

view channel

New Procedure for Laparoscopic Bowel Resection

A novel laparoscopic bowel lifting technique method could help introduce single-incision laparoscopic surgery (SILS) for low anterior resection of rectal cancer. Developed by researchers at Yokohama City University Medical Center (Japan), the laparoscopic bowel-lifting (LBL) technique involves piercing the mesocolon... Read more

Hospital News

view channel

ECG Viewer Integration Transforms Cardiology Medical Records

Community Medical Centers (CMC; Fresno, CA, USA), a leading not-for-profit health system comprised of three hospitals and four outpatient centers in central California, has integrated an electrocardiogram (ECG) management system and viewer into their electronic health record (EHR), leading to significant improvements in... Read more
 
Copyright © 2000-2014 Globetech Media. All rights reserved.