Breech births in twin pregnancy: an analysis of Apgar score and perinatal mortality from a Nigerian sample.
Perinatal mortality (PNM) rates are reported for 146 twin-1 and 192 twin-2 breech births among 622 consecutive twin pairs delivered at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Stillbirths and infants with severe asphyxia (Apgar score 1-3) were recorded in significant proportions of both first and second twin breech infants. PNM rates were 13.7% twin-1, 18.8% twin-2; corrected PNM for infants weighing 2.0 kg or more, were 9.3% and 12.4% for twin-1 and twin-2, respectively. Twin specific breech PNM decreased with increasing birthweight of first and second twin to a low optimum in the weight group 2.5-2.9 kg, and thereafter rose for both first and second twin with birthweight 3.0 kg and above. Factors such as low birthweight, breech/breech presentation, breech extraction and retained second twin breech contributed significantly to the high PNM rates. More favorable PNM rates were recorded among a limited number of breech infants delivered by primary cesarean section for breech/breech or first twin breech presentations. A liberal approach to cesarean section delivery for breech twin births, and particularly for paired breech/breech presentations is strongly advocated.
Fakeye
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Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Nigeria.
D001034:Apgar Score; D001722:Birth Order; D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D009549:Nigeria; D011247:Pregnancy; D012307:Risk Factors; D014427:Twins