Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
Maternal Fetal Medicine Associates, PLLC, New York, New York.
Am J Perinatol. 2020 Nov;37(13):1324-1334. doi: 10.1055/s-0039-1693695. Epub 2019 Jul 25.
This study was aimed to compare maternal and neonatal outcomes between women with twin pregnancies who underwent induction of labor with those women who had planned Cesarean delivery (CD).
This is a retrospective cohort study of women with twin pregnancies ≥ 24 weeks with an indication for delivery but not in labor. Two groups were examined, women who underwent induction and women who underwent planned CD. Maternal and neonatal outcomes were compared between groups both for deliveries at gestational age ≥ 37 weeks and < 37 weeks.
A total of 453 patients were included. Overall, 212 (46.8%) women underwent induction and 241 (53.2%) underwent planned CD. Women who underwent induction of labor had a high rate of VD, both in the term and preterm groups (69.8 and 73.6%, respectively). Women who underwent induction of labor had reduced maternal length of stay, neonatal length of stay, and blood loss, without any increase in adverse outcomes. Neonatal ventilation of either twin delivered < 37 weeks was higher in the CD compared with induction group (27.5 vs. 9.4%, < 0.01), but this was not significant on adjusted odds ratio analysis (aOR = 0.71, 95% CI: 0.19-2.66).
Labor induction in twin gestations have improved maternal outcomes and similar neonatal outcomes compared with planned CD.
本研究旨在比较行引产与计划性剖宫产分娩的双胎妊娠产妇及其新生儿结局。
这是一项回顾性队列研究，纳入了妊娠 24 周以上、有分娩指征但未临产的双胎妊娠妇女。研究比较了行引产和计划性剖宫产的两组产妇的母婴结局，包括在≥37 周和<37 周分娩的产妇。
共纳入 453 例患者。总体而言，212 例（46.8%）产妇行引产，241 例（53.2%）行计划性剖宫产。行引产的产妇，无论是在足月组还是早产组，VD 发生率均较高（分别为 69.8%和 73.6%）。与计划性剖宫产相比，行引产的产妇的产妇住院时间、新生儿住院时间和出血量均减少，但不良结局发生率无增加。<37 周分娩的新生儿中，行剖宫产的双胎中需要通气的比例高于行引产的（27.5%比 9.4%，<0.01），但调整后的优势比分析（aOR=0.71，95%CI：0.19-2.66）显示差异无统计学意义。
与计划性剖宫产相比，双胎妊娠中行引产可改善母婴结局，且新生儿结局相似。
