Introduction: Appropriate intrapartum conduct in a twin delivery remains a challenging aspect of obstetric practice. The objective of this study was to compare neonatal and maternal outcomes in twin pregnancies according to mode of delivery.
Materials And Methods: This is a single centre retrospective cohort study of all consecutive spontaneously-conceived twin deliver-ies (≥ 24 weeks, estimated fetal weight ≥ 500 grams) over a nine-year period between 01/01/2007 - 31/12/2016 at a tertiary-level centre. Neonatal outcomes included survival, APGAR score, prematurity-associated pathology (PAP), admission to the neonatal intensive care unit (NICU) and length of stay (LOS). Maternal outcomes included postpartum complications and LOS. Statistical analysis comprised Chi-square test with subsequent p-value and odds-ratio with 95% confidence interval. Statistical significance was set at p<0.05.
Results: A total of 173 consecutive women with spontaneously-conceived twin deliveries were enrolled in this study, 129 (74.6%) women delivered by caesarean section (CS). The success rate of vaginal delivery (VD) was 93.6% (44/47). A strong statistical correlation was identified between CS and NICU admission; 53.2% vs. 1.5% (p=0.0001). Neonatal LOS in the NICU was significantly longer in the CS group. Prematurity-associated pathology (PAP) was noted in 75 pairs of twins (75/173); 61 pairs were delivered by CS, bearing strong statistical significance (p<0.0001). Postpartum complications occurred in 14.7% of CS compared to 13.6% of VDs.
Conclusion: Neonates delivered by CS had a higher rate of PAP, NICU admission, lower birth weight and longer LOS. This study showed that VD is safe, especially when the first twin is in cephalic presentation.
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http://dx.doi.org/10.3897/folmed.62.e49276 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 167, Beilishi Road, Xicheng District, China.
Background: Heparin, an anticoagulant used in cardiac surgery, can result in heparin rebound (HR), where it returns postoperatively despite being neutralized with protamine. This study was designed to investigate the prevalence of HR in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and evaluate the impact of HR on their short-term outcomes.
Methods: HR was defined by a 10% increase in activated coagulation time (ACT) following two hours of heparin neutralization with protamine, bleeding over 200 mL/h, and abnormal laboratory coagulation examination results.
BMC Pediatr
January 2025
Health Promotion and Health Behavior Department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Background: Complementary feeding is crucial for infant growth, but poor hygiene during this period increases the risk of malnutrition and illness. In Ethiopia, national data on hygiene practices during complementary feeding, particularly among mothers of children aged 6-24 months, is limited. This study aims to synthesize existing data through a systematic review and meta-analysis to evaluate the status of hygiene practices and identify key influencing factors, informing public health strategies to improve child health outcomes.
View Article and Find Full Text PDFBMJ Glob Health
January 2025
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Background: The way that healthcare services are organised and delivered (termed 'healthcare delivery arrangements') is a key aspect of a health system. Changing the way health care is delivered, for example, task shifting that delivers the same care at lower cost, may be one way of improving healthcare system sustainability. We synthesised the existing randomised trial evidence to compare the effects of alternative healthcare delivery arrangements versus usual care in Nepal.
View Article and Find Full Text PDFSleep Health
January 2025
Sleep/Wake Research Centre, Massey University, Wellington, New Zealand. Electronic address:
Objectives: To investigate potential sleep inequities between the infants of Māori and non-Māori mothers in Aotearoa New Zealand, identify socio-ecological factors associated with infant sleep, and determine features of infant sleep that contribute to a mother-perceived infant sleep problem.
Design: Secondary analysis of longitudinal data from the Moe Kura: Mother and Child, Sleep and Well-being in Aotearoa New Zealand study when infants were approximately 12 weeks old.
Participants: 383 Māori and 702 non-Māori mother-infant dyads.
J Pediatr Nurs
January 2025
Department of Health Promotion and Disease Prevention, College of Nursing, University of Tennessee Health Science Center, 847 Union Ave, Memphis, TN 38163, USA.
Purpose: This study examined parenting stress and child special healthcare needs to child neurocognitive development (NCD).
Design And Methods: This secondary analysis used data from the primary study, a longitudinal cohort study of mother-child dyads. Multivariable regression models examined the associations between parenting stress and child special healthcare needs with NCD.
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