Objectives

The aim of this study was to compare neonatal and maternal outcomes in twin pregnancies with elective cesarean section (ECS) and induction of labor (IOL) to better inform women during the counselling process.

Materials and methods

We conducted a cohort study including all twin pregnancies referred to the Department of Obstetrics at Kolding University Hospital, Denmark between January 2007 to April 2019 (n = 819). The primary analysis compared maternal and neonatal outcomes in pregnancies planned for IOL with those planned for ECS after week 34. A secondary analysis compared maternal and neonatal outcomes in pregnancies who underwent IOL followed by successful vaginal delivery with outcomes in those who underwent ECS.

Results

Among 587 eligible twin pregnancies, the rates of unplanned CS did not differ between those planned for ECS compared to those planned for IOL (38% vs. 33%; p = 0.27). IOL resulted in successful vaginal delivery in 67% (155/231) of those planned for IOL. Maternal outcomes did not differ between women who were planned for, or received, delivery with either IOL or ECS. Regarding neonatal outcomes, significantly more neonates required treatment with C-PAP in ECS group, than in the IOL group, and a higher median number of maturity days among mothers planned for ECS. However, no other significant difference in neonatal outcomes was observed when comparing successful IOL with successful ECS.

Conclusion

Induction of labor was not associated with worse outcomes compared to elective caesarean section in this large cohort of routinely handled twin pregnancies. In women with twin pregnancies indicated for delivery, who does not go into spontaneous labor, induction of labor is a safe option for both the mothers and their neonates.

中文翻译：

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与双胎妊娠引产相比，择期剖宫产的新生儿和产妇结局：一项前瞻性队列研究

目标

本研究的目的是比较选择剖宫产 (ECS) 和引产 (IOL) 双胎妊娠的新生儿和产妇结局，以便在咨询过程中更好地告知妇女。

材料和方法

我们进行了一项队列研究，包括 2007 年 1 月至 2019 年 4 月期间转诊至丹麦科灵大学医院产科的所有双胞胎妊娠（n = 819）。主要分析比较了第 34 周后计划接受 IOL 和计划接受 ECS 的孕妇和新生儿的结局。次要分析比较了接受 IOL 随后成功阴道分娩的孕妇和接受 ECS 的孕妇和新生儿的结局。

结果

在 587 例符合条件的双胞胎妊娠中，计划外 CS 的发生率在计划进行 ECS 和计划进行 IOL 的情况下没有差异（38% 对 33%；p = 0.27）。IOL 使 67% (155/231) 计划植入 IOL 的患者成功阴道分娩。计划或接受 IOL 或 ECS 分娩的妇女的产妇结局没有差异。关于新生儿结局，与 IOL 组相比，ECS 组中需要接受 C-PAP 治疗的新生儿明显更多，并且计划接受 ECS 的母亲的成熟天数中位数更高。然而，当比较成功的 IOL 和成功的 ECS 时，没有观察到新生儿结局的其他显着差异。

结论

在这个由常规处理的双胞胎妊娠组成的大型队列中，与择期剖腹产相比，引产与更差的结果无关。对于没有自然分娩的双胞胎孕妇，引产对母亲和新生儿都是安全的选择。