Intervalo entre o Nascimento de Gêmeos: Morbidade e Mortalidade do Segundo Gemelar

Abstract

Purpose: to evaluate the impact of birth time interval between twins in relation to the morbidity and mortality of the second newborn twin. Methods: this is a retrospective study of 50 women with twin pregnancy at the `Maternidade Pró-Matre de Vitória' who gave birth to 100 alive newborns through the vaginal canal, weighing each over 500 g and not having any major malformations. The newborns were separated into two groups: G1 (first twin) and G2 (second twin). The following criteria were considered to be indicative of newborn morbidity: asphyxia at birth, characterized by Apgar index lower than 7 in the first minute of life; respiratory distress syndrome detected by clinical and radiological findings, and hospitalization period longer than 4 days. In-hospital mortality was analyzed as well. Cut off was at every 5 minutes, up to 35 minutes, to study the time interval between the twin (deltat) delivery. A time-span (deltat) analysis was also carried out up to 5 minutes: 6-10, 11-15, 16-20, and 21-150 minutes. Results: there were no statistically significant differences between the second twin's morbidity/mortality in relation to the first, considering the aforesaid cutoff and time-span levels. Conclusion: delivery time interval between G1 and G2 did not influence the second twin's morbidity and mortality; however, in the assistance of the second twin's delivery, it is absolutely necessary to individualize the characteristics of each case, not allowing any anxiety to set in through untimely and potentially damaging procedures.