ABSTRACT
The appropriate time and the optimal mode of delivery of twins are still controversial.
We assessed the effect of gestational age and the mode of elective delivery of twins
on the occurrence of neonatal respiratory morbidity (NRM) and of maternal morbidity.
This study included twins born beyond 35 weeks' gestation. NRM was defined as respiratory
distress syndrome (RDS) and transient tachypnea of the newborn (TTN). Additionally,
maternal complications related to the different modes of delivery were taken into
account. Of 711 twin pregnancies (1422 liveborn neonates) included, 74 (5.2%) experienced
NRM. Maternal age > 25 years, delivery at an earlier gestational age, and delivery
by emergency cesarean section maintained statistical significance with NRM. From the
maternal point of view, increased length of hospitalization (p = 0.045) and the need for postoperative antibiotics (p = 0.0065) were significantly higher following an emergency cesarean section than
after an elective cesarean birth. The risk of NRM in twins born beyond 37 weeks' gestation
is rather low. We suggest considering elective cesarean delivery at completion of
37 weeks. This can be performed safely in regard to NRM, the trade-off being reduced
maternal morbidity associated with elective cesarean delivery.
KEYWORDS
Twins - neonatal respiratory morbidity - elective cesarean section - emergency cesarean
section - respiratory distress syndrome
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Yaniv ZiporiM.D.
Department of Obstetrics and Gynecology
Rambam Health Care Campus, Bat-Galim, Haifa 31096, Israel
eMail: y_zipori@rambam.health.gov.il
