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Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus

OBJECTIVE: To evaluate the efficacy and safety of emergency cerclage (EC) in preterm twins by comparing neonatal outcomes of preterm twins with those of preterm singletons. STUDY DESIGN: This is a single-institution retrospective study of preterm infants born to women who underwent EC from 2008 to 2...

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Autores principales: Chun, Sang Hoon, Chun, Jiyoung, Lee, Keun-Young, Sung, Tae-Jung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258419/
https://www.ncbi.nlm.nih.gov/pubmed/30475916
http://dx.doi.org/10.1371/journal.pone.0208136
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author Chun, Sang Hoon
Chun, Jiyoung
Lee, Keun-Young
Sung, Tae-Jung
author_facet Chun, Sang Hoon
Chun, Jiyoung
Lee, Keun-Young
Sung, Tae-Jung
author_sort Chun, Sang Hoon
collection PubMed
description OBJECTIVE: To evaluate the efficacy and safety of emergency cerclage (EC) in preterm twins by comparing neonatal outcomes of preterm twins with those of preterm singletons. STUDY DESIGN: This is a single-institution retrospective study of preterm infants born to women who underwent EC from 2008 to 2014. We compared various maternal and neonatal factors. The primary and secondary goals were to compare the maternal and neonatal morbidities and neonatal mortality, respectively. RESULTS: One hundred fifty-three infants were included comprising 32(21%) twins and 121(79%) singletons. The mean gestational age (GA) at the time of EC and the number of days from EC to delivery were not significantly different (47.9±27.5 vs. 48.3±35.5). The rate of preterm delivery at ≤32 weeks GA (69% vs. 79%) and ≤28 weeks GA (50% vs. 55%), and other prematurity-associated morbidities were not significantly different. The survival rate during hospitalization was 75% (24/32) in twins and 88% (107/121) in singletons (P = 0.054). Death within 7 days after birth occurred in 8 twins (25%) and 7 singletons (6%) (P = 0.001). All of the infants were <1,000 g with a GA of ≤27 weeks. CONCLUSION: Compared to EC in singleton pregnancies, EC in twin pregnancies resulted in a higher mortality rate for preterm babies. EC might be considered a salvage procedure for selective twin pregnancies with cervical insufficiency.
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spelling pubmed-62584192018-12-06 Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus Chun, Sang Hoon Chun, Jiyoung Lee, Keun-Young Sung, Tae-Jung PLoS One Research Article OBJECTIVE: To evaluate the efficacy and safety of emergency cerclage (EC) in preterm twins by comparing neonatal outcomes of preterm twins with those of preterm singletons. STUDY DESIGN: This is a single-institution retrospective study of preterm infants born to women who underwent EC from 2008 to 2014. We compared various maternal and neonatal factors. The primary and secondary goals were to compare the maternal and neonatal morbidities and neonatal mortality, respectively. RESULTS: One hundred fifty-three infants were included comprising 32(21%) twins and 121(79%) singletons. The mean gestational age (GA) at the time of EC and the number of days from EC to delivery were not significantly different (47.9±27.5 vs. 48.3±35.5). The rate of preterm delivery at ≤32 weeks GA (69% vs. 79%) and ≤28 weeks GA (50% vs. 55%), and other prematurity-associated morbidities were not significantly different. The survival rate during hospitalization was 75% (24/32) in twins and 88% (107/121) in singletons (P = 0.054). Death within 7 days after birth occurred in 8 twins (25%) and 7 singletons (6%) (P = 0.001). All of the infants were <1,000 g with a GA of ≤27 weeks. CONCLUSION: Compared to EC in singleton pregnancies, EC in twin pregnancies resulted in a higher mortality rate for preterm babies. EC might be considered a salvage procedure for selective twin pregnancies with cervical insufficiency. Public Library of Science 2018-11-26 /pmc/articles/PMC6258419/ /pubmed/30475916 http://dx.doi.org/10.1371/journal.pone.0208136 Text en © 2018 Chun et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chun, Sang Hoon
Chun, Jiyoung
Lee, Keun-Young
Sung, Tae-Jung
Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus
title Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus
title_full Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus
title_fullStr Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus
title_full_unstemmed Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus
title_short Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus
title_sort effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: a neonatal focus
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258419/
https://www.ncbi.nlm.nih.gov/pubmed/30475916
http://dx.doi.org/10.1371/journal.pone.0208136
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