Planned Vaginal Delivery vs Planned Cesarean Delivery in Preterm Twins

Study Overview
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Brief Summary
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The incidence of twin pregnancies has increased and currently accounts for 1.8% of all deliveries. 47.5% of twins are born prematurely (vs. 6% for singletons) of which 9.9% before 32SA. Caesarean section rates are also higher than for singletons (53.7% vs 19.2%) and 31.8% of caesarean sections are performed before delivery. The optimal mode of delivery for preterm twins remains controversial. The latest recommendations for clinical practice emphasize that it is not appropriate to recommend one mode of delivery rather than another in the case of twin pregnancies at any term. In view of all these elements, we wished to carry out a retrospective study at the Montpellier University Hospital in order to compare the neonatal outcome of preterms twins according to their mode of delivery : planned vaginal delivery versus planned cesarean delivery.

Official Title
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Planned Vaginal Delivery vs Planned Cesarean Delivery in Preterm Twins

Conditions
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Twin Pregnancy

Intervention / Treatment
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* Other: Survival at discharge
* Other: Survival without severe morbidity


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: twins born at Montpellier University Hospital between 24SA and 32SA+6 January 2010 to July 2019 The mothers must have gone into labour spontaneously or after preterm rupture of membranes first twin in cephalic presentation Exclusion criteria: twin to twin transfusion syndrome monoamniotic pregnancies cause of delivery other than preterm labor or preterm rupture of membranes lethal malformation first twin in breech or transverse presentation
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Planned vaginal delivery<br>Planned vaginal delivery | Other: Survival at discharge<br>* Survival at discharge<br>Other: Survival without severe morbidity<br>* Survival without severe morbidity (IVH, severe BPD, NEC, ROP)<br>|
| Planned cesarean delivery<br>Planned cesarean delivery | Other: Survival at discharge<br>* Survival at discharge<br>Other: Survival without severe morbidity<br>* Survival without severe morbidity (IVH, severe BPD, NEC, ROP)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| survival at discharge and survival | survival at discharge and survival without severe morbidity | during neonatal hospitalization | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| survival at 2 years of corrected | survival at 2 years of corrected | during the first two years corrected age | 
| age without neurosensory impairment | age without neurosensory impairment | during the first two years corrected age | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mode of delivery, Prematurity, Survival at discharge, Survival without severe morbidity