The Association between Intended Mode of Delivery and Maternal Morbidity in Twin Pregnancies.

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.