Evidence map›Paper›PMID 29776396›Full record

ArticleBMC pregnancy and childbirth2018

Delivery of the second twin: influence of presentation on neonatal outcome, a case controlled study.

Gerhard Bogner, Valentina Wallner, Claudius Fazelnia, Martina Strobl, Birgit Volgger, Thorsten Fischer, Volker R Jacobs

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. The Second Twin: Outcomes and Lessons in a Northern Nigerian Tertiary Hospital.Nigerian medical journal : journal of the Nigeria Medical Association
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Gerhard BognerDepartment of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University, Muellner Hauptstr. 48, A-5020, Salzburg, Austria. g.bogner@salk.at.ORCID http://orcid.org/0000-0002-4495-1209
Valentina WallnerParacelsus Medical University, Salzburg, Austria.
Claudius FazelniaDepartment of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University, Muellner Hauptstr. 48, A-5020, Salzburg, Austria.
Martina StroblDepartment of Obstetrics and Gynecology, Hospital of Wels-Grieskirchen, Wels, Austria.
Birgit VolggerDepartment of Obstetrics and Gynecology, Hospital Lienz, Lienz, Tyrol, Austria.
Thorsten FischerDepartment of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University, Muellner Hauptstr. 48, A-5020, Salzburg, Austria.
Volker R JacobsDepartment of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University, Muellner Hauptstr. 48, A-5020, Salzburg, Austria.
Paracelsus Medical University · ATKlinikum Wels-Grieskirchen · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSpontaneous vaginal twin delivery after 32nd week of gestation is safe when first twin presenting cephalic. Aim of this study is to identify obstetric factors influencing the condition of second twin and to verify whether non-cephalic presentation and vaginal breech delivery of the second twin is safe.

methodsThis is a retrospective case controlled cohort study of 717 uncomplicated twin deliveries ≥32 + 0 weeks of gestation from 2005 to 2014 in two tertiary perinatal centers. Obstetric parameters were evaluated in three groups with descriptive, univariate logistic regression analysis for perinatal outcome of second twins.

resultsThe three groups included twins delivered by elective cesarean section ECS (n = 277, 38.6%), by unplanned cesarean section UPC (n = 233, 32.5%) and vaginally (n = 207, 28.9%). Serious adverse fetal outcome is rare and we found no differences between the groups. Second twins after ECS had significant better umbilical artery UA pH (p < 0.001) and better Apgar compared to UPC (p = 0.002). Variables for a fetal population "at risk" for adverse neonatal outcome after vaginal delivery (UA pH < 7.20, Apgar 5´ < 9) were associated with higher gestational age (p = 0.001), longer twin-twin interval (p = 0.05) and vacuum extraction of twin A (p = 0.04). Non-cephalic presentation of second twins was not associated (UA pH < 7.20 OR 1.97, CI 95% 0.93-4.22, p = 0.07, Apgar 5´ < 9 OR 1.63, CI 95% 0.70-3.77, p = 0.25, Transfer to neonatal intermediate care unit p = 0.48). Twenty-one second twins (2,9%) were delivered by cesarean section following vaginal delivery of the first twin. Even though non-cephalic presentation was overrepresented in this subgroup, outcome variables were not significantly different compared to cephalic presentation.

conclusionsEven though elective cesarean means reduced stress for second twins this seems not to be clinically relevant. Non-cephalic presentation of the second twin does not significantly influence the perinatal outcome of the second twin but might be a risk factor for vaginal-cesarean birth.

Indexed as

Labor PresentationPregnancy, TwinAdultCase-Control StudiesCesarean SectionDelivery, ObstetricFemaleGestational AgeHumansInfant, NewbornPregnancyRetrospective StudiesTwinsBreech deliveryDelivery of second twinManagement of twin deliveryMode of deliveryNon-cephalic second twinOutcome second twin

Identifiers

PMID29776396
PMCPMC5960113
OpenAlexW2804384777

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.