• 作者：E. Rebufa-Dhenin ; A. Fl ; rin ; L. Reyftmann ; H. Dechaud ; G. Burlet ; P. Boulot
• 关键词：Grossesse gé ; mellaire ; Cé ; sarienne sur deuxiè ; me jumeau ; Grande extraction du siè ; ge ; Version par man&oelig ; uvres interne
• 刊名：Gynecology Obstetrique & Fertilite
• 出版年：2012
• 出版时间：July-August, 2012
• 年：2012
• 卷：40
• 期：7-8
• 页码：402-405
• 全文大小：311 K

lass=""h4"">Objectives

To evaluate if internal version with ruptured membranes is a risk factor of cesarean section for the second twin.

lass=""h4"">Patients and methods

Two hundred and fifty-nine twins vaginal deliveries after 33 weeks of gestation from 1997 to 2009 in a level 3 maternity. A retrospective case-control study comparing two groups: cases of cesarean section on second twin and five twins vaginal deliveries following the case. Active management of the second twin delivery was performed with a short intertwin delivery.

lass=""h4"">Results

Eleven cesarean sections on the second twin were performed (4.2 % ). The main indication was failure of internal version. The risk of cesarean section was significantly greater when the internal version was performed with ruptured membranes (OR: 25.4 IC 95 % [2.3-275.7] P < 0.003) and when intertwin time delivery interval was increased (8.1 ¡À 5.1 vs 16.7 ¡À 6.3, P < 0.001).

lass=""h4"">Discussion and conclusion

The rupture of amniotic membranes before or during the internal podalic version is associated with a risk of failure and cesarean for the second twin. We recommend to perform the internal podalic version with unruptured membranes according to the French recommendations.