Royal College of Surgeons in Ireland, Dublin, Ireland.
Am J Obstet Gynecol. 2011 Sep;205(3):237.e1-7. doi: 10.1016/j.ajog.2011.05.033. Epub 2011 May 27.
The objective of the study was to establish predictors of vaginal twin birth and evaluate perinatal morbidity according to mode of delivery.
One thousand twenty-eight twin pregnancies were prospectively recruited. For this prespecified secondary analysis, obstetric characteristics and a composite of adverse perinatal outcome were compared according to the success or failure of a trial of labor and further compared with those undergoing elective cesarean delivery. Perinatal outcomes were adjusted for chorionicity and gestational age using a linear model for continuous data and logistic regression for binary data.
Nine hundred seventy-one twin pregnancies met the criteria for inclusion. A trial of labor was considered for 441 (45%) and was successful in 338 of 441 (77%). The cesarean delivery rate for the second twin was 4% (14 of 351). Multiparity and spontaneous conception predicted vaginal birth. No statistically significant differences in perinatal morbidity were observed.
A high prospect of successful and safe vaginal delivery can be achieved with trial of twin labor.
本研究旨在确定阴道分娩的预测因素，并根据分娩方式评估围产期发病率。
前瞻性招募了 1028 例双胎妊娠。对于本预先指定的二次分析，根据试产的成功或失败比较了产科特征和不良围产结局的综合指标，并与选择性剖宫产进行了比较。使用线性模型对连续数据和逻辑回归对二项数据进行调整，以调整胎次和妊娠龄对围产结局的影响。
971 例双胎妊娠符合纳入标准。441 例（45%）考虑试产，其中 338 例（77%）成功。第二胎剖宫产率为 4%（14/351）。多胎妊娠和自然受孕预测阴道分娩。未观察到围产期发病率有统计学显著差异。
通过双胎试产可以实现高成功率和安全性的阴道分娩。
