Mohamed Mahmoud Ahmed Farghali

Ain Shams University , Egypt

Title: Effect of labor epidural analgesia on delivery of second twin: A prospective observational study

Abstract

The delivery of the second twin remains a challenging issue, and the perinatal mortality rate was significantly higher for the retained second twins compared to the unretained second twins. There is no published data regarding the effect of epidural analgesia on delivery of second twin.

Objectives: To evaluate the effect of epidural analgesia on delivery of second twin.

Methods: 343 Women with twin pregnancies planned for trial of vaginal delivery from January 2014 to December 2019 were included in this prospective study. Studied women received lumbar epidural analgesia while parturient in control group received remifentanil intravenous patient-controlled analgesia (IV-PCA) as the insertion of epidural catheter was contraindicated as labor analgesia in this group. According to the mode of delivery of first twin and second twin, participants were classified into; vaginal delivery/vaginal delivery (V/V) group (both twins delivered vaginally), cesarean section/ cesarean section (C/C) group (both twins delivered by cesarean section (CS)), and vaginal delivery/cesarean section (V/C) group (first twin delivered vaginally and second twin delivered by CS). After delivery, the maternal age, parity, gestational age, chorionicity of the twin pregnancies, mode of delivery, fetal weight, and complications associated with labor analgesia were collected to evaluate effect of epidural analgesia on delivery of second twin.

Results: This study found that the risk of requiring delivery by CS for both twins is significantly reduced (P<0.001) if an epidural was used (OR 0.0435; 95%CI:0.022-0.083). Risk of combined V/C for delivery of second twin was significantly reduced if an epidural was used (OR 0.380; 95% CI: 0.163-0.883), (P<0.001).

Conclusion: The use of epidural analgesia in twin pregnancies reduces the CS rate for delivery of both twins and reduces the rate of combined V/C for delivery of second twin. Further future studied are needed to confirm our study findings. Keywords: Epidural analgesia; Second, Twin; Cesarean section; Vaginal delivery.

Biography

MOHAMED M. A. FARGHALI M.D., Professor of obstetrics and Gynecology, Ain Shams University, Egypt. Consultant of Obstetrics and Gynecology, Maternity Sabah Hospital, Kuwait. Professor FARGHALI has completed his M.D. at the age of 33 years from Ain Shams Universiy , Egypt. He has over 30 publications that have been cited over 150 times. He has been serving as an editorial board member of several reputed journals. Editorial Board Member of BMC Women's Health journal. Associate Editor of Frontiers Reproductive Health journal.

4th International Conference on Nursing and Women's Healthcare

Mohamed Mahmoud Ahmed Farghali

Title: Effect of labor epidural analgesia on delivery of second twin: A prospective observational study

Abstract

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