Ghassani A, Ghiduci M-C, Voglimaci M, Chollet C, Parant O
Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 31059 Toulouse cedex 9, France.
Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 31059 Toulouse cedex 9, France; UMR1027, Université de Toulouse III, 31073 Toulouse, France.
J Gynecol Obstet Biol Reprod (Paris). 2015 Mar;44(3):237-45. doi: 10.1016/j.jgyn.2014.05.011. Epub 2014 Jun 13.
The aim of this study was to evaluate the modalities of induction of labour in twin pregnancies compared with singleton pregnancies and to identify risk factors for failure.
A retrospective population-based study was conducted at the Toulouse University Hospital to compare a cohort of diamniotic twin gestations (Twin A in vertex presentation), with induction of labour ≥36 weeks of gestation, between January 2007 and December 2012, to a singleton's cohort that were induced ≥36 weeks of gestation during the 2007 year. One singleton pregnancy was matched for each twin pregnancy with parity and gestational age.
One hundred and fifty-six twins pregnancies met the inclusion criteria for an induction of labor and were compared to 156 single pregnancies. The same and standard protocol of induction of labor was used for the two cohorts (intrauterine balloon catheter±dinoprostone/ocytocine). The cesarean section rate for failed labor induction (cesarean in latent phase) was similar in the 2 populations (14.7% for twin vs 13.5% for single; P=0.66). The factors associated to failed induction of labor in the total population were nulliparity (OR=1.49) and Bishop score<6 at the beginning of the induction (OR=2.83).
Twin did not appear as risk of failed induction. The protocol for induction of labor in singletons may be safely proposed to twin gestations.
本研究旨在评估双胎妊娠与单胎妊娠引产的方式，并确定引产失败的危险因素。
在图卢兹大学医院进行了一项基于人群的回顾性研究，以比较2007年1月至2012年12月期间妊娠≥36周的双羊膜囊双胎妊娠队列（头先露的双胎A）与2007年期间妊娠≥36周的单胎妊娠队列。每例双胎妊娠匹配1例单胎妊娠，使其产次和孕周相同。
156例双胎妊娠符合引产纳入标准，并与156例单胎妊娠进行比较。两组队列采用相同的标准引产方案（子宫内球囊导管±地诺前列酮/缩宫素）。引产失败（潜伏期剖宫产）的剖宫产率在两组人群中相似（双胎为14.7%，单胎为13.5%；P=0.66）。总体人群中与引产失败相关的因素为初产（OR=1.49）和引产开始时Bishop评分<6（OR=2.83）。
双胎并非引产失败的危险因素。单胎妊娠的引产方案可安全地应用于双胎妊娠。
