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Breathnach, FM;McAuliffe, FM;Geary, M;Daly, S;Higgins, JR;Dornan, J;Morrison, JJ;Burke, G;Higgins, S;Dicker, P;Manning, F;Carroll, S;Malone, FD
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Prediction of safe and successful vaginal twin birth
2011
September
Published
1
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2ND TWIN PERINATAL-MORTALITY CESAREAN DELIVERY RETROSPECTIVE COHORT NEONATAL MORBIDITY GESTATIONAL-AGE PREGNANCIES MODE MANAGEMENT DEATH
OBJECTIVE: The objective of the study was to establish predictors of vaginal twin birth and evaluate perinatal morbidity according to mode of delivery.STUDY DESIGN: One thousand twenty-eight twin pregnancies were prospectively recruited. For this prespecified secondary analysis, obstetric characteristics and a composite of adverse perinatal outcome were compared according to the success or failure of a trial of labor and further compared with those undergoing elective cesarean delivery. Perinatal outcomes were adjusted for chorionicity and gestational age using a linear model for continuous data and logistic regression for binary data.RESULTS: Nine hundred seventy-one twin pregnancies met the criteria for inclusion. A trial of labor was considered for 441 (45%) and was successful in 338 of 441 (77%). The cesarean delivery rate for the second twin was 4% (14 of 351). Multiparity and spontaneous conception predicted vaginal birth. No statistically significant differences in perinatal morbidity were observed.CONCLUSION: A high prospect of successful and safe vaginal delivery can be achieved with trial of twin labor.
10.1016/j.ajog.2011.05.033
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