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Trial of labour in twin pregnancies: a retrospective cohort study
- Source :
- BJOG : an international journal of obstetrics and gynaecology. 123(6)
- Publication Year :
- 2015
-
Abstract
- Objective To assess the success rate of vaginal delivery among women with twin pregnancies; the Twin Birth Study has shown that vaginal delivery and caesarean section are equally safe for twin delivery but >40% of the planned vaginal delivery group delivered by caesarean section. Design A retrospective cohort study. Setting A tertiary medical centre. Population A total of 2194 women with twin pregnancies not complicated with very low birthweight. Methods Planned mode of delivery was documented in the woman's electronic record upon entering the delivery room. Information regarding maternal age at delivery, parity, gestational age, presentation, previous history of caesarean delivery, birthweight and Apgar score was collected from the obstetric electronic charts. Main outcome measured Rate of vaginal twin delivery. Results Of the 2194 women included, 1311 twin pregnancies had planned caesarean delivery and 883 underwent a trial of labour. Of the 883 women who underwent a trial of labour, the rate of vaginal delivery was 86.9%, whereas the rates of caesarean delivery and combined vaginal–caesarean delivery were 11.1% and 2.0%, respectively. Presentation of second twin, gestational age and maternal age did affect the chances of success. Nulliparity [odds ratio (OR) 2.38, 95% confidence interval (95% CI) 1.4–4.05], Foley induction of labour (OR 2.33, 95% CI 1.38–3.91) and body mass index >30 kg/m2 (OR 1.76, 95% CI 1.03–3) were independent risk factors for caesarean delivery. Conclusions The rate of vaginal delivery among women with twin pregnancies who undergo labour can be high, especially in women who laboured spontaneously and have delivered before. Tweetable abstract The rate of vaginal delivery of twins can be high, especially in women who have delivered before.
- Subjects :
- Adult
medicine.medical_specialty
medicine.medical_treatment
Population
Gestational Age
Patient Care Planning
Body Mass Index
Labor Presentation
03 medical and health sciences
0302 clinical medicine
Pregnancy
Risk Factors
medicine
Humans
Caesarean section
030212 general & internal medicine
Amnion
Labor, Induced
education
reproductive and urinary physiology
Retrospective Studies
Gynecology
education.field_of_study
030219 obstetrics & reproductive medicine
Obstetrics
Vaginal delivery
business.industry
Cesarean Section
Trial of labour
Parturition
Obstetrics and Gynecology
Gestational age
Retrospective cohort study
Odds ratio
Trial of Labor
Parity
Pregnancy, Twin
Apgar score
Female
business
Maternal Age
Subjects
Details
- ISSN :
- 14710528
- Volume :
- 123
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- BJOG : an international journal of obstetrics and gynaecology
- Accession number :
- edsair.doi.dedup.....6a1f1c5f5e67a00f53a3f5239b62ddfd