title: Effect of mode of delivery on neonatal outcome of monochorionic diamniotic twin pregnancies: a retrospective cohort study.
abstract: OBJECTIVE
  To assess whether vaginal delivery increases the risk of adverse neonatal outcome among uneventful monochorionic diamniotic twin pregnancies.
  
  
  METHODS
  We conducted a retrospective controlled cohort study on 112 uneventful monochorionic diamniotic twin pregnancies at > or = 34 weeks' gestation. The outcomes of 52 monochorionic diamniotic twins delivered vaginally were compared with those of 172 monochorionic diamniotic twins delivered by cesarean section.
  
  
  RESULTS
  Five babies (2.9%) in the cesarean section group had a 5-minute Apgar score < 7 and needed orotracheal intubation, whereas in the vaginal delivery group no 5-minute Apgar score < 7 or orotracheal intubation occurred (p = 0.002). Delivery by cesarean section presented higher rates of admission to neonatal intensive care unit (62 out of 172 babies delivered by cesarean section compared to 3 out of 52 babies delivered vaginally, p < 0.001). There were no cases of intrapartum twin-to-twin transfusion syndrome or neonatal death at time of hospital discharge in either group.
  
  
  CONCLUSIONS
  Vaginal delivery appears to be a good management option in uneventful monochorionic diamniotic twin pregnancies after 34 weeks' gestation.
authors: Department of Obstetrics and Gynaecology, Hospital de S. João, Porto, Portugal. minespestana@gmail.com
authors: Inês
authors: I
authors: Pestana
authors: Teresa
authors: T
authors: Loureiro
authors: Amélia
authors: A
authors: Almeida
authors: Ilda
authors: I
authors: Rocha
authors: Rosa Maria
authors: RM
authors: Rodrigues
authors: Teresa
authors: T
authors: Rodrigues
mesh_terms: D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007442:Intubation, Intratracheal; D007743:Labor, Obstetric; D011247:Pregnancy; D059285:Pregnancy, Twin; D012189:Retrospective Studies; D055815:Young Adult