A Randomized Trial of Planned Cesarean or Vaginal Delivery for Twin Pregnancy

In this randomized trial comparing delivery strategies in women with twin gestation, planned cesarean section did not significantly increase or decrease the risk of fetal or neonatal death or serious neonatal morbidity, as compared with planned vaginal delivery. Because of assisted reproductive tech...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 369; no. 14; pp. 1295 - 1305
Main Authors Barrett, Jon F.R, Hannah, Mary E, Hutton, Eileen K, Willan, Andrew R, Allen, Alexander C, Armson, B. Anthony, Gafni, Amiram, Joseph, K.S, Mason, Dalah, Ohlsson, Arne, Ross, Susan, Sanchez, J. Johanna, Asztalos, Elizabeth V
Format Journal Article
LanguageEnglish
Published Waltham, MA Massachusetts Medical Society 03.10.2013
Subjects
Adult
Biological and medical sciences
Birth
Cesarean section
Cesarean Section - statistics & numerical data
Childbirth & labor
Delivery, Obstetric - methods
Delivery, Obstetric - statistics & numerical data
Evidence-based medicine
Female
Fetal Death - prevention & control
Fetuses
General aspects
Gestation
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases - prevention & control
Medical sciences
Morbidity
Neonates
Obstetrics
Perinatal Mortality
Pregnancy
Pregnancy Outcome
Pregnancy, Twin
Time Factors
Twins
Ultrasonic imaging
Vagina
Medicine
Vagina
Twin pregnancy
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Summary:In this randomized trial comparing delivery strategies in women with twin gestation, planned cesarean section did not significantly increase or decrease the risk of fetal or neonatal death or serious neonatal morbidity, as compared with planned vaginal delivery. Because of assisted reproductive technologies, twin pregnancy occurs more frequently now than in the past, and it complicates 2 to 3% of all births. 1 , 2 Twins are at higher risk for an adverse perinatal outcome than singletons. 3 , 4 Planned cesarean section, as compared with planned vaginal delivery, may reduce this risk. 5 Although a small, randomized, controlled trial did not show better perinatal outcomes with planned cesarean section than with planned vaginal delivery, 6 several cohort studies have shown a reduced risk of adverse perinatal outcomes for both twins, or for the second twin, when twins at or near term were delivered . . .
Bibliography:ObjectType-Article-1
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The members of the Twin Birth Study Collaborative Group are listed in the Supplementary Appendix, available at NEJM.org.
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMoa1214939