Outcomes Similar for Planned Twin C-Section, Vaginal Delivery

Findings in twins between 32 and 38 weeks of gestation with first twin in cephalic presentation

Outcomes Similar for Planned Twin C-Section, Vaginal Delivery

WEDNESDAY, Oct. 2 (HealthDay News) -- There is no increase or decrease in serious neonatal morbidity or mortality with either planned cesarean section or vaginal delivery for twins between 32 and 38 weeks of gestation, with the first twin in the cephalic presentation, according to a study published in the Oct. 3 issue of the New England Journal of Medicine.

Jon F.R. Barrett, M.D., from the Sunnybrook Health Sciences Centre in Toronto, and colleagues randomly assigned 1,398 women (between 32 weeks 0 days and 38 weeks 6 days gestation with twin pregnancy and first twin in the cephalic presentation) to planned cesarean delivery, and 1,406 women to vaginal delivery. A composite of fetal or neonatal death or serious neonatal morbidity was the primary outcome.

The researchers found that the rate of cesarean delivery was 90.7 percent in the planned-cesarean-delivery group and 43.8 percent in the planned-vaginal-delivery group. Deliveries were significantly earlier among women in the planned-cesarean-delivery group compared to those in the planned-vaginal-delivery group (mean number of days from randomization to delivery, 12.4 versus 13.3; P = 0.04). The composite primary outcome did not significantly differ between the groups (odds ratio with planned cesarean delivery, 1.16; P = 0.49).

"In twin pregnancy between 32 weeks 0 days and 38 weeks 6 days of gestation, with the first twin in the cephalic presentation, planned cesarean delivery did not significantly decrease or increase the risk of fetal or neonatal death or serious neonatal morbidity, as compared with planned vaginal delivery," the authors write.

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