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Perinatal Mortality in Multiple Pregnancy Patients

Published online by Cambridge University Press:  01 August 2014

F.P. Meehan ,
I.M. Magani  and
G. Mortimer
F.P. Meehan*
Affiliation:
Celtic International Clinical Research Unit, Department of Obstetrics and Gynaecology, University College Galway, Ireland
I.M. Magani
Affiliation:
Celtic International Clinical Research Unit, Department of Obstetrics and Gynaecology, University College Galway, Ireland
G. Mortimer
Affiliation:
Celtic International Clinical Research Unit, Department of Obstetrics and Gynaecology, University College Galway, Ireland
*
Celtic International Clinical Research Unit, Department of Obstetrics and Gynaecology, University College, Galway, Ireland

Abstract

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A study of perinatal mortality in multiple pregnancy over a period of 12 years, 1972 to 1984, showed prematurity and low birthweight as the major causes of fetal loss. The highest risk was found at 28 to 30 weeks gestation (306/1,000). There was a significantly greater risk to babies delivered by the breech (136/1,000), and likewise in the second twin when compared with the first, ratio 1:1.4. A significant drop in the perinatal mortality rate, from 98/1,000 to 39/1,000, was observed between 1972-1978 and 1979-1984. Ultrasound has facilitated the earlier diagnosis of twins and provides more accurate serial fetal assessment. Bedrest, more vigilant antenatal care, intrapartum surveillance and improved neonatal care, are required to maintain and further reduce the perinatal mortality rate. When regional analgesia was employed in labour, the number of babies lost was 41/1,000, vs 93/1,000 in patients not receiving regional analgesia. External cephalic version and vertex delivery of the second twin is preferable to internal version and breech extraction. It should also be contemplated, as an alternative to elective cesarean section for a transverse lie or brrech presentation of the second fetus.

Keywords

Perinatal mortalityMultiple pregnancyPrematurityBirthweightBreechRegional analgesiaUltrasound
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 37 , Issue 3-4 , October 1988 , pp. 331 - 337
Copyright
Copyright © The International Society for Twin Studies 1988

References

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