Open AccessEvidence that women with a history of cesarean section can deliver twins safely
Author(s) -
Odeh Marwan,
Tarazova Lidiya,
Wolfson Margareth,
Oettinger Moshe
Publication year - 1997
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016349709024607
Subject(s) - medicine , gestation , neonatal intensive care unit , obstetrics , gestational age , apgar score , elective cesarean section , vaginal delivery , randomized controlled trial , birth weight , pregnancy , intensive care unit , dehiscence , gynecology , surgery , pediatrics , genetics , biology
Objective. To determine whether a trial of labor is safe in twin pregnancies after one previous cesarean section. Study design. Retrospective analysis of all cases of multiple pregnancies after cesarean section during the years 1970‐1993, including twin gestations after one cesarean section. Results. Forty‐six cases of multiple gestations were found, 36 of which were eligible for the study presented herein. Fifteen women (41.7%) were denied trial of labor. Twenty‐one women (58.3%) were allowed trial of labor, 17 (80.9%) of whom were delivered vaginally and four (19.1%) by a repeated cesarean section. The group of trial of labor was compared to the group of elective cesarean section. Hospitalization period was 4.4±1.9 days and 8.0±2.6 days in the trial of labor group and elective cesarean section group, respectively ( p <0.01). Blood transfusions required were 9.5% and 26.6% in both groups, respectively (NS). Puerperial infections were 9.5% in the trial of labor group, compared to 46.6% in the elective cesarean section group (NS). No scar dehiscence occurred in either groups. There were no statistically significant differences in age, parity, gestational age at delivery, mean newborn weight, Apgar score at one and five minutes, Neonatal Intensive Care Unit admission and mean Neonatal Intensive Care Unit stay. Conclusions. Vaginal delivery in twin gestation after one previous cesarean section may be considered in appropriate cases. A large multicentral randomized prospective study may further confirm this conclusion.