Induction of Labor versus Cesarean Delivery in Twin Pregnancies

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.

Prediction of successful labor induction with very unfavorable cervix: A comparison of six scores

“…However, the inclusion and exclusion criteria used in our study do not allow us to generalize our findings to every pregnancy circumstance. Further studies, including twin pregnancies and premature deliveries, must be conducted to confirm our results in those populations 13,16 . Moreover, external validity should be discussed because we worked with a French population sample.…”

“…These analyses make an important contribution to the literature because of the sparse information concerning predictive scores in this specific population in addition to the well-known higher risk of induction failure. 12,13 Another key highlight of our work is that we compared the current scores with each other instead of proposing a new score. 11,14,15 However, the inclusion and exclusion criteria used in our study do not allow us to generalize our findings to every pregnancy circumstance.…”

“…Further studies, including twin pregnancies and premature deliveries, must be conducted to confirm our results in those populations. 13,16 Moreover, external validity should be discussed because we worked with a French population sample.…”

“…We also decided to analyze women with an unfavorable cervix (Bishop score <3) at induction, which is a common clinical practice situation. These analyses make an important contribution to the literature because of the sparse information concerning predictive scores in this specific population in addition to the well‐known higher risk of induction failure 12,13 . Another key highlight of our work is that we compared the current scores with each other instead of proposing a new score 11,14,15 …”

Cesarean sections and early-term births according to Robson classification: a population-based study with more than 17 million births in Brazil

“…Studies have shown that there is an increased risk of perinatal mortality and morbidity when a twin pregnancy continues beyond 37 weeks, and that lower risks are seen when twins are born between 36 and 38 weeks [ 31 , 32 ]. Our study findings of our study may indicate the higher indication (preference) of a CS as a type of delivery for multiple pregnancies, although the safest method for delivering twins at term, or close to term, remains a controversial issue [ 33 – 35 ].…”