Is the protocol for induction of labor in singletons applicable to twin gestations?

ABSTRACT

OBJECTIVE: To evaluate the success of induction of labor in twin gestations using standard protocols for misoprostol and oxytocin designed for singleton gestations. STUDY DESIGN: This retrospective cohort study involved all diamniotic twin gestations that were induced at > or = 32 weeks' gestation with intact membranes. Two singleton pregnancies were matched for each twin pregnancy. Use of intravaginal misoprostol and low-dose intravenous oxytocin was based on ACOG management guidelines. RESULTS: A small proportion (40 of 430 [9.3%]) of twins met the inclusion criteria for an induction of labor. Misoprostol was utilized less frequently with twins than with singletons (55% vs. 78%, p = 0.02) because of the higher preinduction Bishop score. Doses of oxytocin were comparable between the 2 groups. A high rate of vaginal delivery was seen in the twin and singleton groups (85.0% vs. 80.0%, p = 0.62) with similar neonatal outcomes. CONCLUSION: A standard protocol of labor induction for singleton gestations would apply for twins with overall favorable intrapartum outcomes.