Trial of vaginal delivery for twins - is it safe? a single center experience

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Dana Sadeh-MestechkinTal Biron-Shental

Abstract

This study assessed our hospital protocol of vaginal delivery for twins and evaluated whether trial of vaginal delivery (unless contraindicated) was as safe as elective cesarean. Risk factors leading to failed trial of labor (TOL) were characterized to improve our ability to advise patients and select cases for TOL. This retrospective, cohort study included women >32 weeks gestation, with twin A in cephalic presentation and no contraindications for vaginal delivery. Controls were women with twin pregnancy and planned cesarean delivery (PCD). Maternal and neonatal morbidity between TOL and PCD were compared. TOL group was subcategorized by vaginal or cesarean delivery to characterize pre-labor risk factors for failed TOL. Of the 411 twins, 215 had TOL and 196 had PCD. Among TOL, 196/215 (91%) delivered vaginally. TOL was more likely to have spontaneous pregnancy, pregnancy complications and tended to deliver earlier. More TOL had postpartum hemorrhage (p < .05), although transfusion rates in each group were similar. Neonatal outcomes between groups did not differ. Induction and gestational age at delivery were risk factors for failed TOL. The results support the contemporary practice of TOL for twins at term when the first is in...Continue Reading

References

Nov 2, 2002·BMJ : British Medical Journal·Gordon C S SmithRichard Dobbie
Jan 28, 2003·American Journal of Obstetrics and Gynecology·Karen L HogleMary E Hannah
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
Mar 5, 2005·American Journal of Obstetrics and Gynecology·Qiuying YangMark Walker
Jul 28, 2005·BJOG : an International Journal of Obstetrics and Gynaecology·Gordon C S SmithRichard Dobbie
Nov 25, 2005·Journal of Perinatology : Official Journal of the California Perinatal Association·Q YangM Walker
Sep 2, 2006·Obstetrics and Gynecology·B Anthony ArmsonThomas F Baskett
Feb 5, 2011·BJOG : an International Journal of Obstetrics and Gynaecology·A C RossiR H Chmait
Oct 22, 2011·Obstetrics and Gynecology·Henry C LeeYair J Blumenfeld
Oct 4, 2013·The New England Journal of Medicine·Jon F R BarrettUNKNOWN Twin Birth Study Collaborative Group
Feb 21, 2014·Obstetrics and Gynecology·UNKNOWN American College of Obstetricians and Gynecologists, UNKNOWN Society for Maternal-Fetal Medicine
Mar 1, 2014·BJOG : an International Journal of Obstetrics and Gynaecology·D J WenckusI Wilkins
Aug 5, 2014·American Journal of Obstetrics and Gynecology·Nathan S FoxAndrei Rebarber
Nov 8, 2015·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Simone M T A GoossensFrans J M E Roumen

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Citations

Dec 20, 2018·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Sara G J YeohPeter Y A Lee

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