Am J Perinatol 2020; 37(13): 1324-1334
DOI: 10.1055/s-0039-1693695
Original Article

Induction of Labor versus Cesarean Delivery in Twin Pregnancies

Kelly B. Zafman
1  Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
,
Andrei Rebarber
1  Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
2  Maternal Fetal Medicine Associates, PLLC, New York, New York
,
Stephanie Melka
1  Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
2  Maternal Fetal Medicine Associates, PLLC, New York, New York
,
Mariam Naqvi
1  Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
2  Maternal Fetal Medicine Associates, PLLC, New York, New York
,
Nathan S. Fox
1  Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
2  Maternal Fetal Medicine Associates, PLLC, New York, New York
› Author Affiliations

Abstract

Objective This study was aimed to compare maternal and neonatal outcomes between women with twin pregnancies who underwent induction of labor with those women who had planned Cesarean delivery (CD).

Study Design This is a retrospective cohort study of women with twin pregnancies ≥ 24 weeks with an indication for delivery but not in labor. Two groups were examined, women who underwent induction and women who underwent planned CD. Maternal and neonatal outcomes were compared between groups both for deliveries at gestational age ≥ 37 weeks and < 37 weeks.

Results A total of 453 patients were included. Overall, 212 (46.8%) women underwent induction and 241 (53.2%) underwent planned CD. Women who underwent induction of labor had a high rate of VD, both in the term and preterm groups (69.8 and 73.6%, respectively). Women who underwent induction of labor had reduced maternal length of stay, neonatal length of stay, and blood loss, without any increase in adverse outcomes. Neonatal ventilation of either twin delivered < 37 weeks was higher in the CD compared with induction group (27.5 vs. 9.4%, p < 0.01), but this was not significant on adjusted odds ratio analysis (aOR = 0.71, 95% CI: 0.19–2.66).

Conclusion Labor induction in twin gestations have improved maternal outcomes and similar neonatal outcomes compared with planned CD.



Publication History

Received: 08 February 2019

Accepted: 07 June 2019

Publication Date:
25 July 2019 (online)

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