Neonatal and maternal outcomes in twin gestations ≥32 weeks according to the planned mode of delivery

Objective: To determine a possible relationship between neonatal and maternal outcomes in twin gestations and the planned mode of delivery. Study design: A single-centre retrospective cohort study in twins >= 32 weeks of gestational age was performed. Baseline characteristics, and neonatal and maternal outcomes were documented according to the planned mode of delivery: a planned caesarean section or a planned vaginal birth. Statistical analysis was performed using chi-square test. Fisher exact test was used in case correction was needed. Results: During the study period (1999-2002), 164 twins >= 32 weeks were enrolled in the study. In 29 women (17.7%) an elective caesarean section was performed. The remaining 135 twins (82.3%) were allowed to start a vaginal delivery. An emergency or an urgent secondary caesarean section for both twins was performed in 26 women, and in 2 women for twin B only. One twin B baby died during planned vaginal delivery. No significant differences in perinatal mortality and serious neonatal morbidity were found between both groups (10.3% versus 9.6%). Neonatal outcomes in twins A were significantly better than in twins B (2.4% versus 7.3%), independent of the planned mode of delivery. Serious maternal morbidity was not significantly different between both groups (13.8% versus 19.3%), although 2 women in the elective caesarean section group needed a relaparotomy for haemorrhage. Conclusion: Our results do not support an elective caesarean section for twin gestations >= 32 weeks. The success rate of vaginal delivery in the planned vaginal birth group was nearly 80%. (C) 2005 Elsevier Ireland Ltd. All rights reserved.