Twin Delivery After a Previous Caesarean: A Twelve-Year Experience |
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| Affiliation: | 1. Department of Obstetrics and Gynecology, Ste-Justine Hospital, University of Montreal, Montreal QC;2. Department of Maternal-Fetal Medicine, Hutzel Hospital, Wayne State University, Detroit MI;1. Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, Illinois;2. College of Nursing, University of Illinois at Chicago, Chicago, Illinois;1. Wits Obstetrics and Gynaecology Clinical Research Division, University of the Witwatersrand, Johannesburg 2193, South Africa;2. Center for Global Health, Massachusetts General Hospital, Boston, MA, USA;3. Harvard Medical School, Boston, MA, USA;1. Service d’orthopédie dento-faciale, faculté de médecine dentaire de Rabat, université Mohamed V Souissi, centre de consultation et de traitements dentaires, centre hospitalier Ibn-Sina Rabat-Salé, avenue Allal-el-Fassi, rue Mohammed-Jazouli, cité Al-Irfane, BP 6212, Rabat Instituts, Maroc;2. Laboratoire de biostatistique et de recherche clinique et épidémiologie, faculté de médecine et pharmacie de Rabat, Rabat, Maroc;3. Service d’odontologie chirurgicale, CCTD-CH Ibn-Sina Rabat-Salé, Rabat, Maroc;4. Service de prothèse adjointe, CCTD-CH Ibn-Sina Rabat-Salé, Rabat, Maroc;1. Univ. Lille, EA 4489, Perinatal Environment and Health, F-59000 Lille, France;2. CHU Lille, Department of Obstetrics, F-59000 Lille, France;3. CHU Lille, CIC-IT 1403, MRRC, F-59000 Lille, France;4. CHU Lille, Department of Pediatric Surgery, F-59000 Lille, France;5. CHU Lille, Department of Neonatology, F-59000 Lille, France;1. Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province, College of Life Sciences, Anhui Normal University, Wuhu, Anhui 241000, China;2. Alligator Research Center of Anhui Province, Xuanzhou 242000, China |
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| Abstract: | ![]()
Objectives: To compare maternal and neonatal morbidities between trial of labour (TOL) and elective Caesarean section in women with twin pregnancies who have had a prior Caesarean.Methods: An observational study was conducted of women with a prior Caesarean who delivered twins at 28 weeks’ gestation or greater in Ste-Justine Hospital between 1988 and 2001. Maternal and neonatal outcomes were compared between women who had a TOL (group I) and those who had an elective Caesarean delivery (group 2).Results: Twenty-six women and 52 fetuses were included in group 1 and compared to the 71 women and 142 fetuses in group 2. Maternal age, gestational age, and birth weight were comparable in both groups. In group 1, 22 (85%) out of 26 women delivered twin A vaginally and 19 (73%) delivered both vaginally. There was no significant difference in the umbilical artery cord pH, Apgar score, ventilatory support, and admission to the neonatal intensive care unit between the 2 groups. There was also no significant difference in the rate of postpartum maternal fever or decrease of serum hemoglobin between the 2 groups, but the median hospital stay was higher in the group with elective Caesarean (5.0 vs. 3.0 days, p <0.001). There were no uterine ruptures or other major complications in either group.Conclusion: There were no significant differences in maternal and neonatal morbidity outcomes between births by trial of labour and by elective Caesarean, in twin pregnancies after a prior Caesarean section. A trial of labour is associated with a shorter hospital stay. |
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| Keywords: | Vaginal birth after Caesarean maternal morbidity twin pregnancy |
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