Prediction of safe and successful vaginal twin birth

Royal College of Surgeons in Ireland, Dublin, Ireland.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 05/2011; 205(3):237.e1-7. DOI: 10.1016/j.ajog.2011.05.033
Source: PubMed


The objective of the study was to establish predictors of vaginal twin birth and evaluate perinatal morbidity according to mode of delivery.
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.
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.
A high prospect of successful and safe vaginal delivery can be achieved with trial of twin labor.

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