Translating data to dialogue: how to discuss mode of delivery with your patient with twins

American Journal of Obstetrics and Gynecology
Marjorie C Meyer

Abstract

Patients are given options with regard to the mode of delivery with increasing frequency. The manner in which obstetricians frame the risk/benefit information can have dramatic impact on the ultimate decision made by the patient. Recently published epidemiologic data reported increased morbidity and mortality to the second twin on the basis of mode of delivery. In this analysis, the findings of the epidemiologic studies were translated from odds ratio into the number of cesarean deliveries that would be required to prevent an adverse outcome for the second twin. For gestations of > or = 36 weeks, 97 cesarean deliveries would need to be performed to prevent a single serious morbidity or mortality in a second twin. This number is within the range needed to prevent uterine rupture associated with trial of labor following cesarean delivery (556) or morbidity related to vaginal breech delivery (167). Number needed to treat may be more useful than odds risk assessment in patient counseling.

References

Jun 30, 1988·The New England Journal of Medicine·A LaupacisR S Roberts
Oct 1, 1993·Journal of General Internal Medicine·D J MalenkaJ M Ross
Jun 1, 1996·Journal of General Internal Medicine·S V RajkumarA B Gustafson
Nov 21, 2000·American Journal of Obstetrics and Gynecology·E L Mozurkewich, E K Hutton
Apr 12, 2002·The New England Journal of Medicine·John D BirkmeyerDavid E Wennberg
Sep 13, 2002·American Journal of Epidemiology·Michael S KramerUNKNOWN Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System
Jan 6, 2004·Obstetrics and Gynecology·Wendy SheayWendy L Kinzler
Oct 7, 2004·American Journal of Obstetrics and Gynecology·Shi Wu WenMark Walker
Oct 7, 2004·American Journal of Obstetrics and Gynecology·Shi Wu WenMark Walker
Nov 19, 2004·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·F W MakohaT Ghabra
Jan 27, 2005·American Journal of Obstetrics and Gynecology·Eftichia V KontopoulosAnthony M Vintzileos
Mar 5, 2005·American Journal of Obstetrics and Gynecology·Qiuying YangMark Walker

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Citations

Mar 29, 2013·Archives of Gynecology and Obstetrics·Andreja Trojner-BregarIsaac Blickstein
Oct 22, 2011·Obstetrics and Gynecology·Henry C LeeYair J Blumenfeld
Feb 17, 2007·Journal of Perinatal Medicine·Teresinha SimõesIsaac Blickstein
Jun 21, 2012·Seminars in Perinatology·Young Mi Lee
Feb 10, 2010·Journal de gynécologie, obstétrique et biologie de la reproduction·F VendittelliD Lémery
Jul 3, 2009·Journal de gynécologie, obstétrique et biologie de la reproduction·T SchmitzF Goffinet
Apr 28, 2009·Gynécologie, obstétrique & fertilité·L SentilhesG Kayem
Mar 24, 2011·Acta Obstetricia Et Gynecologica Scandinavica·Françoise VendittelliUNKNOWN Perinatal Sentinel Network, AUDIPOG
Mar 1, 2015·American Journal of Obstetrics and Gynecology·Loïc SentilhesGilles Kayem
Mar 4, 2008·Obstetrics and Gynecology·Thomas SchmitzFrançois Goffinet
Dec 12, 2018·Obstetrics and Gynecology·Loïc SentilhesUNKNOWN Etude Epidémiologique sur les Petits Ages Gestationnels (EPIPAGE) 2 Obstetric Writing Group

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