Prediction of safe and successful vaginal twin birth

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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. © 2011 Mosby, Inc.

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Breathnach, F. M., McAuliffe, F. M., Geary, M., Daly, S., Higgins, J. R., Dornan, J., … Malone, F. D. (2011). Prediction of safe and successful vaginal twin birth. In American Journal of Obstetrics and Gynecology (Vol. 205, pp. 237.e1-237.e7). Mosby Inc.

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