• J. Matern. Fetal. Neonatal. Med. · Dec 2012

    Comparative Study

    Mode of delivery and neonatal outcome in uncomplicated monochorionic twin pregnancies.

    • Boaz Weisz, Liat Hogen, Yoav Yinon, Shali Mazaki, Liat Gindes, Eyal Schiff, and Shlomo Lipitz.
    • Department of Obstetrics and gynecology, Sheba Medical Center , Tel-Hashomer 52621 , Israel and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. boazmd@zahav.net.il
    • J. Matern. Fetal. Neonatal. Med. 2012 Dec 1;25(12):2721-4.

    ObjectiveThe association between of mode of delivery and perinatal morbidity in monochorionic (MC) twins is not clear. Thus there is no agreement regarding the optimal mode of delivery of MC twins. The aim of this study is to determine the impact of the mode of delivery on neonatal outcome of uncomplicated MC twins in a tertiary center with a strict policy of delivering MC twins by 37 weeks' gestation.MethodsRetrospective analysis of all uncomplicated MC twin deliveries at a tertiary referral hospital during a 5-year period. Complicated MC pregnancies (fetal death, selective reduction, twin to twin transfusion syndrome, fetal growth restriction of one or both twins or major fetal anomalies) were excluded. Induction of labor or planned caesarean sections of uncomplicated MC pregnancies was conducted between 35 and 37 weeks of gestation. Neonatal outcomes of MC twins were compared according to the mode of delivery. Moreover, mode of delivery was compared with a control group of 1934 dichorionic (DC) twin pregnancies delivered during the same period.ResultsThe rate of Caesarean section was 63.4% in uncomplicated MC/DA twins pregnancies and this was similar to our rate in DC twins (61%, p = 0.65). Multivariate analysis revealed that adverse neonatal outcome was significantly associated with gestational age at delivery, neonatal birth weight discordance and male gender but not with the intended or actual mode of delivery.ConclusionDelivering MC twin pregnancies by 37 weeks' gestation is associated with similar rate of vaginal deliveries compared with DC twin pregnancies. The neonatal outcome was not affected by the mode of delivery, and therefore vaginal delivery seems safe in MC twins.

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