Cesarean delivery or induction of labor in pre-labor twin gestations: A secondary analysis of the Twin Birth Study (original) (raw)

Cesarean Delivery for the Second Twin

Obstetrics & Gynecology, 2008

Objective-To examine maternal and infant outcomes after a vaginal delivery of twin A and a cesarean delivery of twin B, and to identify whether the second twin experienced increased shortterm morbidity as part of a combined route of delivery. January 1, 1999 and December 31, 2000, a prospective cohort study of all cesarean deliveries was conducted at 13 university centers. This secondary analysis was limited to women with twin gestations who experienced labor and underwent cesarean delivery. We compared outcomes of the second twin in women who had vaginal delivery of the first twin and a cesarean delivery of the second twin to those who had cesarean delivery of both twins. Results-One-thousand twenty-eight twin pregnancies experienced labor and underwent cesarean delivery, 179 (17%) had a combined vaginal/cesarean delivery. Gestational age at delivery was 34.6 weeks in both groups (p = 0.97). The rupture of membranes to delivery interval was longer in the combined group (3.2 vs 2.3 hrs, p < 0.001). Endometritis and culture proven sepsis in the second twin were more common in the combined group, respectively (n=24, OR 1.6, 95% CI, 1.0 -2.7), (n=15, OR 1.8, 95% CI, 1.0 -3.4). These differences were not significant after logistic regression analysis. There were no statistically significant differences in an arterial cord pH of less than 7.0, Apgar less than or equal to 3 at 5 minutes, seizures, grade 3 or 4 IVH, HIE or neonatal death. Conclusion-Combined twin delivery may be associated with endometritis and neonatal sepsis when compared to a twin delivery where both are delivered by cesarean in twin pregnancies

Pre-labor Cesarean delivery or induction of labor in twin gestation

2020

BACKGROUND: We aimed to compare neonatal and maternal outcomes of twin gestations without spontaneous onset of labor, which underwent induction of labor or pre-labor cesarean section.METHODS: In the Twin Birth Study (TBS), women at 320/7-386/7 weeks of gestation, in whom the first twin was in cephalic presentation, were randomized to planned vaginal delivery or cesarean section. In this secondary analysis of the TBS we focused on the outcomes of the subset of women who did not have a spontaneous onset of labor. We compared those who had an induction of labor with those who had a pre-labor cesarean section. The primary outcome was a composite of fetal or neonatal death or serious neonatal morbidity. Secondary outcome was a composite of maternal morbidity and mortality.RESULTS: Of the 2,804 women included in the TBS, a total of 1,347 (48%) women did not have a spontaneous onset of labor: 568 (42%) in the planned vaginal delivery arm and 779 (58%) in the planned cesarean arm. Induction...