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Article ; Online: The vanishing twin: Diagnosis and implications.

Batsry, Linoy / Yinon, Yoav

Best practice & research. Clinical obstetrics & gynaecology

2022 Volume 84, Page(s) 66–75

Abstract: Vanishing twin syndrome (VTS), defined by first-trimester spontaneous loss of a twin, is a common phenomenon with a reported prevalence of 15-35% of twin pregnancies. The etiology of VTS is obscure. Still, several risk factors have been identified, ... ...

Abstract	Vanishing twin syndrome (VTS), defined by first-trimester spontaneous loss of a twin, is a common phenomenon with a reported prevalence of 15-35% of twin pregnancies. The etiology of VTS is obscure. Still, several risk factors have been identified, including an increased number of embryos transferred in pregnancies conceived by in vitro fertilization, an initial increased number of gestational sacs and advanced maternal age. The effect of VTS on obstetric and perinatal outcomes is controversial. Several studies have reported that pregnancies with VTS were associated with increased risk for preterm birth and small for gestational age neonates compared to singleton pregnancies, while others showed no difference in perinatal outcomes. The prevalence of placental vascular and anatomic abnormalities such as small placentas was higher in VTS. These findings lay an essential foundation for understanding how this phenomenon affects obstetric and perinatal outcomes of the surviving pregnancy.
MeSH term(s)	Infant, Newborn ; Pregnancy ; Female ; Humans ; Premature Birth/epidemiology ; Premature Birth/etiology ; Retrospective Studies ; Placenta ; Abortion, Spontaneous/epidemiology ; Pregnancy, Twin
Language	English
Publishing date	2022-03-30
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2050090-7
ISSN	1532-1932 ; 1521-6934
ISSN (online)	1532-1932
ISSN	1521-6934
DOI	10.1016/j.bpobgyn.2022.03.009
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Article ; Online: Vaginal delivery rate by near delivery sonographic weight estimation and maternal stature among nulliparous women.

Meyer, Raanan / Yinon, Yoav / Levin, Gabriel

Birth (Berkeley, Calif.)

2022 Volume 50, Issue 3, Page(s) 557–564

Abstract: Background: We evaluated the risk for cesarean delivery among term nulliparous women, categorized by maternal stature and recent sonographic estimated fetal weight (EFW).: Methods: A retrospective study including singleton deliveries of nulliparous ... ...

Abstract	Background: We evaluated the risk for cesarean delivery among term nulliparous women, categorized by maternal stature and recent sonographic estimated fetal weight (EFW). Methods: A retrospective study including singleton deliveries of nulliparous women between 2011 and 2020, with sonographic EFW within 1 week of delivery. We categorized maternal height into five groups: ≤150, 151-155, 156-160, 161-165, and ≥166 cm. Fetal weight estimation was categorized into five groups as well: ≤2500 g, 2501-2999, 3000-3499, 3500-3999, and ≥4000 g. Results: Overall, 13 107 deliveries were included. The cesarean delivery rate was inversely correlated with maternal height, ranging from 41.0% in group 1 to 13.1% in group 5. The vaginal delivery rate ranged from 33.3% in maternal height group 1 with EFW of ≥4000 g to 85% in maternal height group 5 with EFW of ≤2500 g. In weight categories above 2500 g, maternal height correlated significantly with vaginal delivery rate, except in weight category ≥4000 g in which vaginal delivery rate ranged around 30% in maternal height categories 1-3 and increased significantly in groups 4-5 to 50-60%. In multivariable logistic regression analysis, EFW was independently associated with CD for EFW categories 3500-3999 and ≥4000 g [aOR 95% CI 1.49 (1.08-2.06) and 4.39 (2.97-6.50), respectively]. Maternal height was negatively associated with CD [aOR 95% CI 0.67 (0.64-0.70)] for each increase in maternal height group. Conclusions: Cesarean delivery rate was inversely correlated with maternal height, ranging from 41.0% among women ≤150 cm to 13.1% among women ≥166 cm. Maternal height and EFW of ≥3500 g are independently associated with CD rates among term nulliparous women.
MeSH term(s)	Pregnancy ; Female ; Humans ; Fetal Weight ; Retrospective Studies ; Ultrasonography, Prenatal ; Delivery, Obstetric ; Cesarean Section
Language	English
Publishing date	2022-09-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	604869-9
ISSN	1523-536X ; 0730-7659
ISSN (online)	1523-536X
ISSN	0730-7659
DOI	10.1111/birt.12679
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Zs.B 2442: Show issues

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Article ; Online: Intrauterine Blood Transfusion for Parvo B19-Induced Fetal Anemia: Neuroimaging Findings and Long-Term Neurological Outcomes.

Berezowsky, Alexandra / Hochberg, Alyssa / Regev, Noam / Weisz, Boaz / Lipitz, Shlomo / Yinon, Yoav

Fetal diagnosis and therapy

2023 Volume 50, Issue 3, Page(s) 206–214

Abstract: Introduction: We aimed to evaluate the neuroimaging findings and long-term neurodevelopmental outcomes of fetuses and children following intrauterine blood transfusion (IUT) for parvo B19 infection-induced anemia compared to those with RBC ... ...

Abstract	Introduction: We aimed to evaluate the neuroimaging findings and long-term neurodevelopmental outcomes of fetuses and children following intrauterine blood transfusion (IUT) for parvo B19 infection-induced anemia compared to those with RBC alloimmunization. Methods: We conducted a retrospective cohort study including women who underwent an IUT due to fetal anemia between 2006 and 2019 in a tertiary, university-affiliated medical center. The cohort was divided into two groups: a study group - fetuses affected by congenital parvo B19 infection; and a control group - fetuses affected by RBC alloimmunization. Retrospective data such as antenatal sonographic evaluations, fetal brain MRI results, and short-term fetal and neonatal outcomes were collected. All children underwent a neurodevelopmental evaluation after birth using a Vineland questionnaire. Primary outcome was defined as the presence or absence of neurodevelopmental delay. Secondary outcome was defined as the presence of abnormal fetal neuroimaging findings such as cerebellar hypoplasia, polymicrogyria, intracranial hemorrhage, or severe ventriculomegaly. Results: Overall, 71 fetuses requiring at least one IUT were included in the study. Of these, 18 were affected by parvo B19 infection and 53 by RBC alloimmunization with various associated antibodies. Fetuses in the parvo B19 group presented at an earlier gestational age (22.91 ± 3.36 weeks vs. 27.37 ± 4.67 weeks, p = 0.002) and were more affected by hydrops (93.33% vs. 16.98%, p < 0.001). Three fetuses out of the 18 (16.67%) fetuses in the parvo B19 group died in utero following the IUT. Abnormal neuroimaging findings were detected in 4/15 (26.7%) of the parvo B19 survivors versus 2/53 (3.8%) of fetuses affected by RBC alloimmunization (p = 0.005). There was no difference in long-term neurodevelopmental delay rates between the children in the study and control groups, as assessed at the average age of 3.65 and 6.53 years, accordingly. Conclusion: Fetal anemia due to parvo B19, treated with IUT, might be associated with increased rates of abnormal neurosonographic findings. The correlation between those findings and long-term adverse neurodevelopmental outcomes requires further investigation.
MeSH term(s)	Child ; Infant, Newborn ; Pregnancy ; Female ; Humans ; Child, Preschool ; Infant ; Retrospective Studies ; Blood Transfusion, Intrauterine/methods ; Parvovirus B19, Human ; Parvoviridae Infections ; Fetal Diseases/diagnostic imaging ; Fetal Diseases/therapy ; Anemia/diagnostic imaging ; Anemia/etiology ; Anemia/therapy ; Neuroimaging
Language	English
Publishing date	2023-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1066460-9
ISSN	1421-9964 ; 1015-3837
ISSN (online)	1421-9964
ISSN	1015-3837
DOI	10.1159/000530993
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Zs.A 2146: Show issues

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Article ; Online: Prediction of meconium aspiration syndrome by data available before delivery.

Amitai Komem, Daphna / Meyer, Raanan / Yinon, Yoav / Levin, Gabriel

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2021 Volume 158, Issue 3, Page(s) 551–556

Abstract: Objective: To identify risk factors associated with the occurrence of meconium aspiration syndrome (MAS) among neonates.: Methods: A retrospective case-control study in a university affiliated tertiary medical center, including all neonates born with ...

Abstract	Objective: To identify risk factors associated with the occurrence of meconium aspiration syndrome (MAS) among neonates. Methods: A retrospective case-control study in a university affiliated tertiary medical center, including all neonates born with meconium stained amniotic fluid (MSAF) between March 2011 and March 2020. Patients were categorized by the occurrence of MAS. Demographic, pregnancy and delivery characteristics were compared between the two groups. Risk factors for MAS were analyzed. Results: Of 90 579 singleton deliveries, a total of 11 856 with MSAF were included. Of these newborns, 78 (0.66%) were diagnosed with MAS Four factors were independently associated with MAS: delivery at <38 0/7 weeks (aOR [95% CI]: 3.48 (1.02-11.84), P = 0.046); higher body mass index (aOR [95% CI]: 1.09 (1.02-1.16), P = 0.003); lower amniotic fluid index (aOR [95% CI]: 0.99 (0.98-0.99), P = 0.032); higher white blood cell count (aOR [95% CI]: 1.11 (1.02-1.20), P = 0.009). The presence of one, two and three of the above-mentioned risk factors yielded a risk for MAS of 0.8%, 2.5% and 100%, respectively. Conclusion: We identified independent risk factors for MAS and developed a risk score calculator. This tool may assist physicians in the management of deliveries complicated by MSAF.
MeSH term(s)	Amniotic Fluid ; Case-Control Studies ; Female ; Humans ; Infant, Newborn ; Meconium ; Meconium Aspiration Syndrome/diagnosis ; Meconium Aspiration Syndrome/epidemiology ; Meconium Aspiration Syndrome/etiology ; Pregnancy ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2021-12-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14034
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Zs.A 355: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Obstetric and Early Neonatal Outcomes Following Second and Third COVID-19 Vaccination in Pregnancy.

Peretz-Machluf, Ravit / Gilboa, Mayan / Bookstein-Peretz, Shiran / Segal, Omri / Regev, Noam / Meyer, Raanan / Regev-Yochay, Gili / Yinon, Yoav / Toussia-Cohen, Shlomi

The Israel Medical Association journal : IMAJ

2024 Volume 26, Issue 1, Page(s) 12–17

Abstract: Background: Pregnant women are at higher risk for severe coronavirus disease 2019 (COVID-19). Since the release of the BNT162b2 messenger RNA vaccine (Pfizer/BioNTech), there has been accumulated data about the three vaccine doses. However, information ... ...

Abstract	Background: Pregnant women are at higher risk for severe coronavirus disease 2019 (COVID-19). Since the release of the BNT162b2 messenger RNA vaccine (Pfizer/BioNTech), there has been accumulated data about the three vaccine doses. However, information regarding obstetric and neonatal outcomes of pregnant women vaccinated with the third (booster) vaccine is limited and primarily retrospective. Objectives: To evaluate the obstetric and early neonatal outcomes of pregnant women vaccinated during pregnancy with the COVID-19 booster vaccine compared to pregnant women vaccinated only by the first two doses. Methods: We conducted a cross-sectional study of pregnant women who received the BNT162b2 vaccine during pregnancy. Obstetric and neonatal outcomes were compared between pregnant women who received only the first two doses of the vaccine to those who also received the booster dose. Results: Overall, 139 pregnant women were vaccinated during pregnancy with the first two doses of the vaccine and 84 with the third dose. The third dose group received the vaccine earlier during their pregnancy compared to the two doses group (212 vs. 315 weeks, respectively, P < 0.001). No differences in obstetric and early neonatal outcomes between the groups were found except for lower rates of urgent cesarean delivery in the third dose group (adjusted odds ratio 0.21; 95% confidence interval 0.048-0.926, P = 0.039). Conclusions: Compared to the first two doses of the BNT162b2 vaccine given in pregnancy, the booster vaccination is safe and not associated with an increased rate of adverse obstetric and early neonatal outcomes.
MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; Humans ; COVID-19 Vaccines/adverse effects ; BNT162 Vaccine ; COVID-19/epidemiology ; COVID-19/prevention & control ; Cross-Sectional Studies ; Retrospective Studies ; Vaccination
Chemical Substances	COVID-19 Vaccines ; BNT162 Vaccine
Language	English
Publishing date	2024-02-28
Publishing country	Israel
Document type	Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Zs.A 5470: Show issues

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Article ; Online: Second stage expedite delivery of low birth weight neonates: Emergent cesarean delivery versus vacuum assisted delivery.

Levin, Gabriel / Rottenstreich, Amihai / Cahan, Tal / Mankuta, David / Yagel, Simcha / Yinon, Yoav / Meyer, Raanan

Journal of gynecology obstetrics and human reproduction

2021 Volume 50, Issue 8, Page(s) 102136

Abstract: Objective: To determine maternal and neonatal outcomes among women undergoing second stage emergent cesarean delivery (ECD) versus vacuum-assisted delivery (VAD) of low birthweight neonates.: Materials and methods: A retrospective cohort study from ... ...

Abstract	Objective: To determine maternal and neonatal outcomes among women undergoing second stage emergent cesarean delivery (ECD) versus vacuum-assisted delivery (VAD) of low birthweight neonates. Materials and methods: A retrospective cohort study from two tertiary medical centers. We included women who underwent either ECD or VAD during the second stage of labor, and delivered neonates with a birthweight of <2500 g during 2011-2019. Characteristics and outcomes were compared between the groups. The primary outcome was the rate of a composite adverse neonatal outcome, defined as the presence of ≥1 of the following: Apgar 5 min < 7, respiratory distress syndrome, neonatal intensive care unit admission, mechanical ventilation and intrapartum fetal death. Results: The study cohort included 611 patients, of whom 46 had ECD and 565 had VAD. Baseline characteristics did not differ between the groups. The rate of Apgar score < 7 at 1 min was higher among the ECD group]10 (22%) vs. 29 (5%), OR (95% CI) 5.1 (2.3-11.3), p < 0.001[. Other neonatal and maternal outcomes were similar in both groups. Conclusions: Neonatal and maternal outcomes do not differ substantially between ECD and VAD of neonates weighing <2500 g. This information may be useful when contemplating the preferred mode of delivery in this setting.
MeSH term(s)	Adult ; Cesarean Section/standards ; Cesarean Section/statistics & numerical data ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Labor Stage, Second/physiology ; Pregnancy ; Retrospective Studies ; Time Factors ; Vacuum Extraction, Obstetrical/standards ; Vacuum Extraction, Obstetrical/statistics & numerical data
Language	English
Publishing date	2021-04-02
Publishing country	France
Document type	Journal Article
ISSN	2468-7847
ISSN (online)	2468-7847
DOI	10.1016/j.jogoh.2021.102136
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Article ; Online: Is endothelial function impaired among women with placenta-mediated fetal growth restriction? Evidence from a prospective cohort study using peripheral artery tonometry.

Kirshenbaum, Michal / Topaz, Lior / Baum, Micha / Mazaki-Tovi, Shali / Yinon, Yoav

Placenta

2021 Volume 109, Page(s) 32–36

Abstract: Introduction: Women with pregnancies complicated by IUGR are at increased risk for future cardiovascular disease. Nevertheless, it is unknown whether endothelial function of women with pregnancies complicated by IUGR is already impaired during pregnancy. ...

Abstract	Introduction: Women with pregnancies complicated by IUGR are at increased risk for future cardiovascular disease. Nevertheless, it is unknown whether endothelial function of women with pregnancies complicated by IUGR is already impaired during pregnancy. Hence, we evaluated maternal endothelial function in pregnancies complicated by IUGR due to placental dysfunction. Methods: Prospective cohort study assessing systemic endothelial function of women with singleton pregnancies and estimated fetal weight (EFW) below 10th percentile and abnormal umbilical artery flow (n = 15). Control group included women with singleton pregnancies and normal EFW (n = 22). Endothelial function was assessed using EndoPAT™ device which evaluates the change in peripheral vascular tone in reaction to temporal ischemia, a process called reactive hyperemia. The ratio of the readings before and after ischemia is used to assess endothelial function and called reactive hyperemia index (RHI). Low RHI values indicate endothelial dysfunction. Results: The median gestational age at endoPAT examination was comparable between the IUGR and control groups (32; IQR 31,33; p = 0.18). The median RHI was significantly lower in the IUGR group compared to the control group (1.3 vs 1.5, p = 0.02). Median gestational age at delivery and mean neonatal birth weight were lower in the IUGR group compared to the control group (36.7 (35.6,37.2) vs 37.7 (35.3, 39.3), p = 0.04 and 1647 ± 414 g vs 2785 ± 587 g, p < 0.001). Discussion-: Pregnant women with IUGR due to placental dysfunction are characterized by impaired systemic endothelial function.
MeSH term(s)	Adult ; Cohort Studies ; Endothelium, Vascular/diagnostic imaging ; Endothelium, Vascular/physiopathology ; Female ; Fetal Growth Retardation/diagnosis ; Fetal Growth Retardation/physiopathology ; Humans ; Infant, Newborn ; Male ; Manometry ; Placenta/diagnostic imaging ; Placenta/pathology ; Placenta/physiopathology ; Placenta Diseases/diagnosis ; Placenta Diseases/pathology ; Placenta Diseases/physiopathology ; Pregnancy ; Prospective Studies ; Pulsatile Flow ; Ultrasonography, Prenatal ; Umbilical Arteries/diagnostic imaging ; Umbilical Arteries/physiopathology ; Uterine Artery/diagnostic imaging ; Uterine Artery/physiopathology
Language	English
Publishing date	2021-04-27
Publishing country	Netherlands
Document type	Journal Article ; Observational Study
ZDB-ID	603951-0
ISSN	1532-3102 ; 0143-4004
ISSN (online)	1532-3102
ISSN	0143-4004
DOI	10.1016/j.placenta.2021.04.013
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Zs.A 1578: Show issues

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Article ; Online: Abnormal nuchal translucency followed by normal microarray analysis is associated with placental pathology-related complications.

Krispin, Eyal / Kushnir, Anya / Shemer, Asaf / Rienstein, Shlomit / Berkenstadt, Michal / Yinon, Yoav / Weisz, Boaz

Prenatal diagnosis

2021 Volume 41, Issue 7, Page(s) 855–860

Abstract: Objective: Identify placental pathology-related complications, labor and neonatal outcomes in pregnancies complicated by pathological nuchal translucency (NT) with normal microarray analysis.: Methods: A retrospective study in which all women with ... ...

Abstract	Objective: Identify placental pathology-related complications, labor and neonatal outcomes in pregnancies complicated by pathological nuchal translucency (NT) with normal microarray analysis. Methods: A retrospective study in which all women with singleton pregnancy who demonstrated NT above 3 mm and a normal microarray analysis were matched to women with normal NT and a normal microarray analysis (2013-2019) in a single tertiary academic center. The following placental pathology-related parameters were measured: preeclampsia, oligohydramnios, suspected intrauterine growth restriction, abnormal Doppler studies or small for gestational age (SGA) neonates. The primary outcome was defined as a composite of complications related to placental pathology including preeclampsia and SGA neonate. Secondary outcomes were labor complications and neonatal morbidity. Results: A total of 185 women were included in the study: of them, 47 presented an abnormal NT (study group) and 138 presented normal NT (controls). Groups did not significantly differ in baseline characteristics. Regarding primary outcome, all placental-related complications frequencies were higher in the study group, with a composite rate of 17.02% versus 6.52% in controls (p = 0.042%). Secondary outcomes did not differ between groups. Conclusions: Abnormal NT measurement presented in pregnancies with normal fetal microarray analysis is associated with higher rates of placental-related complications.
MeSH term(s)	Adult ; Cohort Studies ; Female ; Humans ; Infant, Newborn ; Middle Aged ; Nuchal Translucency Measurement/instrumentation ; Nuchal Translucency Measurement/methods ; Nuchal Translucency Measurement/statistics & numerical data ; Placenta/pathology ; Pregnancy ; Pregnancy Outcome/epidemiology ; Retrospective Studies ; Tissue Array Analysis/methods ; Tissue Array Analysis/statistics & numerical data
Language	English
Publishing date	2021-01-25
Publishing country	England
Document type	Journal Article
ZDB-ID	82031-3
ISSN	1097-0223 ; 0197-3851
ISSN (online)	1097-0223
ISSN	0197-3851
DOI	10.1002/pd.5896
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Zs.A 1625: Show issues

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Article ; Online: Hematologic adaptation to mask-wearing among pregnant women and obstetrical outcome during the coronavirus disease 2019 pandemic.

Friedrich, Lior / Levin, Gabriel / Maixner, Nitzan / Bart, Yossi / Tsur, Abraham / Yinon, Yoav / Meyer, Raanan

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2021 Volume 154, Issue 2, Page(s) 297–303

Abstract: Objective: To evaluate the effect of the coronavirus disease 2019 (COVID-19) mask-wearing on hematological laboratory components and obstetrical outcomes among women delivering during the COVID-19 pandemic.: Methods: Laboratory results and ... ...

Abstract	Objective: To evaluate the effect of the coronavirus disease 2019 (COVID-19) mask-wearing on hematological laboratory components and obstetrical outcomes among women delivering during the COVID-19 pandemic. Methods: Laboratory results and obstetrical outcomes of women with singleton gestations, admitted for delivery during the COVID-19 mask-wearing period (April-June 2020) were compared with those of women delivering during the parallel period in 2019 and with a larger cohort derived from nine pre-pandemic years (March 2011-April 2020). Results: Overall, 1838 women delivered during the COVID-19 pandemic. Compared with the pre-pandemic period, mean hemoglobin and fibrinogen levels were significantly higher during the mask-wearing period (12.15 ± 1.1 vs 11.96 ± 1.2, P < 0.001 and 472 ± 103.6 vs 448 ± 85.1 mg/dl, P < 0.001, respectively). Platelet levels were lower (200 ± 56.0 vs 206 ± 57.5 K/µl, P < 0.001). The rate of delivery at <34 weeks of gestation was lower during the mask-wearing period (1.1% vs 2%, odds ratio [OR] 0.57, 95% confidence intervals [CI] 0.37-0.88, P = 0.01), whereas cesarean delivery and postpartum hemorrhage rates were higher (26.7% vs 24.4%, OR 1.13, 95% CI 1.02-1.25, P = 0.022 and 4.1% vs 2.8%, OR 1.5, 95% CI 1.2-1.8, P = 0.001, respectively). Conclusion: A hard-to-ventilate space created by wearing a mask during the COVID-19 era may be the underlying cause of the observed higher hemoglobin level among pregnant women, possibly affecting obstetrical outcomes.
MeSH term(s)	Adult ; Blood Platelets ; COVID-19/epidemiology ; COVID-19/prevention & control ; Cesarean Section/statistics & numerical data ; Cohort Studies ; Female ; Fibrinogen/analysis ; Hemoglobins/analysis ; Hospitalization ; Humans ; Masks ; Pandemics ; Pregnancy ; Pregnant Women/psychology ; SARS-CoV-2 ; Term Birth
Chemical Substances	Hemoglobins ; Fibrinogen (9001-32-5)
Language	English
Publishing date	2021-05-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.13715
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Article ; Online: Labor induction in twin pregnancies: Does the perinatal outcome differ according to chorionicity?

Krispin, Eyal / Zlatkin, Rita / Weisz, Boaz / Mazaki-Tovi, Shali / Yinon, Yoav

Archives of gynecology and obstetrics

2021 Volume 306, Issue 1, Page(s) 93–100

Abstract: Objective: To compare perinatal outcomes following induction of labor in dichorionic versus monochorionic twin pregnancies.: Study design: A retrospective cohort study analyzing all women with twin pregnancies who underwent induction of labor in a ... ...

Abstract	Objective: To compare perinatal outcomes following induction of labor in dichorionic versus monochorionic twin pregnancies. Study design: A retrospective cohort study analyzing all women with twin pregnancies who underwent induction of labor in a single university-affiliated tertiary medical center. The cohort included 290 women who were divided into 2 groups according to chorionicity: (1) dichorionic twin pregnancies (n = 203); (2) monochorionic twin pregnancies (n = 87). Induction of labor methods included oxytocin infusion, extra-amniotic balloon catheter and artificial amniotomy. Primary outcome was defined as mode of delivery. Secondary outcomes included maternal and neonatal adverse events. Results: Primary outcome did not differ between groups, with vaginal delivery rate of 92.1% in the dichorionic group and 94.2% in the monochorionic group. Women with dichorionic twins delivered later compared to monochorionic twins (38.00 weeks vs. 36.43 weeks, respectively, p < 0.001). While no differences were observed in Apgar scores or umbilical cord pH measurements, dichorionic twins were less frequently admitted to the neonatal intensive care unit compared to monochorionic twins (2.4% vs. 3.4%, p = 0.01 for 1st twin; and 6.9% vs. 10.3%, p = 0.089 for 2nd twin). Multivariate logistic regression adjusting outcomes to potential confounders, found gestational age at delivery to be the only variable significantly associated with neonatal intensive care unit admission rates (odds ratio 0.236, 95% confidence interval 0.152-0.366, p < 0.001). Conclusion: Labor induction might be considered for both di- and monochorionic uncomplicated twin pregnancies with excellent vaginal delivery rates. The higher rates of neonatal adverse outcomes among monochorionic twins are presumably related to earlier gestation age at delivery.
MeSH term(s)	Chorion ; Delivery, Obstetric/methods ; Female ; Humans ; Infant, Newborn ; Labor, Induced ; Pregnancy ; Pregnancy Outcome/epidemiology ; Pregnancy, Twin ; Retrospective Studies
Language	English
Publishing date	2021-10-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-021-06272-8
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