Am J Perinatol 2019; 36(07): 695-700
DOI: 10.1055/s-0038-1673655
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Association between Intended Mode of Delivery and Maternal Morbidity 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
,
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
,
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
,
James Miller
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
,
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
,
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
Further Information

Publication History

15 June 2018

30 August 2018

Publication Date:
29 October 2018 (online)

Zoom Image

Abstract

Objective To compare maternal morbidity between women undergoing delivery of twins who intend to labor with those women who do not intend to labor.

Study Design This was a retrospective cohort study of women undergoing delivery of twins in a single maternal–fetal medicine practice between January 2005 and February 2018. We identified women with a twin delivery at gestational age ≥24 weeks and determined if they intended or did not intend to labor. Maternal outcomes were compared between the groups.

Results A total of 788 patients were included, of whom 404 (51.3%) intended to labor and 384 (48.7%) did not intend to labor. Women who intended to labor had a high rate of vaginal delivery (VD; 79.7%). Overall, 45 (5.7%) women required blood transfusion; this was not significantly different between the groups (6.2 vs. 5.2%, p = 0.54). Women who intended to labor had a shorter hospital stay and lower blood loss. There were no significant differences for all other maternal outcomes.

Conclusion In patients undergoing twin delivery, women who intend to labor have similar maternal morbidity compared with women who do not intend to labor. This supports current guidelines recommending providers offer a trial of VD for twin pregnancies.