The Maternal-Fetal Medicine Unit cesarean registry: Trial of labor with a twin gestation

Michael W. Varner, Sharon Leindecker, Catherine Y. Spong, Atef H. Moawad, John C. Hauth, Mark B. Landon, Kenneth J. Leveno, Steve N. Caritis, Margaret Harper, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Marshall Carpenter, Alan Peaceman, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Susan M. Ramin, Brian M. MercerSteven G. Gabbe

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: The purpose of this study was to identify the success rates and risks in women with a twin pregnancy who attempt a trial of labor after cesarean delivery. Study design: Cases were identified in the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network's Cesarean Registry with a woman with a twin pregnancy who had had at least 1 previous cesarean delivery. Results: During the study period (1999-2002), 412 women fulfilled the study criteria, and 226 women had elective repeat cesarean delivery. Of the 186 women (45.1% of total) who attempted a trial of labor, 120 women were delivered successfully (success rate, 64.5%), and 66 women (35.5%) had a failed trial of labor. Thirty of the failed trials of labor involved a vaginal delivery for twin A and cesarean delivery for twin B. Women who attempted a trial of labor with twins had no increased risk of transfusion, endometritis, intensive care unit admissions, or uterine rupture when compared with elective repeat cesarean delivery. Fetal and neonatal complications were uncommon in either group at ≥34 weeks of gestation. Conclusion: A trial of labor with twins after previous cesarean delivery does not appear to increase maternal morbidity. Perinatal morbidity is uncommon at ≥34 weeks of gestation.

Original languageEnglish
Pages (from-to)135-140
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume193
Issue number1
DOIs
StatePublished - Jul 1 2005
Externally publishedYes

Fingerprint

Trial of Labor
Registries
Mothers
Medicine
Pregnancy
Twin Pregnancy
National Institute of Child Health and Human Development (U.S.)
Uterine Rupture
Morbidity
Endometritis
Intensive Care Units

Keywords

  • Previous cesarean delivery
  • Trial of labor
  • Twins

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Varner, M. W., Leindecker, S., Spong, C. Y., Moawad, A. H., Hauth, J. C., Landon, M. B., ... Gabbe, S. G. (2005). The Maternal-Fetal Medicine Unit cesarean registry: Trial of labor with a twin gestation. American Journal of Obstetrics and Gynecology, 193(1), 135-140. https://doi.org/10.1016/j.ajog.2005.03.023

The Maternal-Fetal Medicine Unit cesarean registry : Trial of labor with a twin gestation. / Varner, Michael W.; Leindecker, Sharon; Spong, Catherine Y.; Moawad, Atef H.; Hauth, John C.; Landon, Mark B.; Leveno, Kenneth J.; Caritis, Steve N.; Harper, Margaret; Wapner, Ronald J.; Sorokin, Yoram; Miodovnik, Menachem; Carpenter, Marshall; Peaceman, Alan; O'Sullivan, Mary J.; Sibai, Baha M.; Langer, Oded; Thorp, John M.; Ramin, Susan M.; Mercer, Brian M.; Gabbe, Steven G.

In: American Journal of Obstetrics and Gynecology, Vol. 193, No. 1, 01.07.2005, p. 135-140.

Research output: Contribution to journalArticle

Varner, MW, Leindecker, S, Spong, CY, Moawad, AH, Hauth, JC, Landon, MB, Leveno, KJ, Caritis, SN, Harper, M, Wapner, RJ, Sorokin, Y, Miodovnik, M, Carpenter, M, Peaceman, A, O'Sullivan, MJ, Sibai, BM, Langer, O, Thorp, JM, Ramin, SM, Mercer, BM & Gabbe, SG 2005, 'The Maternal-Fetal Medicine Unit cesarean registry: Trial of labor with a twin gestation', American Journal of Obstetrics and Gynecology, vol. 193, no. 1, pp. 135-140. https://doi.org/10.1016/j.ajog.2005.03.023
Varner, Michael W. ; Leindecker, Sharon ; Spong, Catherine Y. ; Moawad, Atef H. ; Hauth, John C. ; Landon, Mark B. ; Leveno, Kenneth J. ; Caritis, Steve N. ; Harper, Margaret ; Wapner, Ronald J. ; Sorokin, Yoram ; Miodovnik, Menachem ; Carpenter, Marshall ; Peaceman, Alan ; O'Sullivan, Mary J. ; Sibai, Baha M. ; Langer, Oded ; Thorp, John M. ; Ramin, Susan M. ; Mercer, Brian M. ; Gabbe, Steven G. / The Maternal-Fetal Medicine Unit cesarean registry : Trial of labor with a twin gestation. In: American Journal of Obstetrics and Gynecology. 2005 ; Vol. 193, No. 1. pp. 135-140.
@article{6df0ce58408049289c41b93f0af8f0af,
title = "The Maternal-Fetal Medicine Unit cesarean registry: Trial of labor with a twin gestation",
abstract = "Objective: The purpose of this study was to identify the success rates and risks in women with a twin pregnancy who attempt a trial of labor after cesarean delivery. Study design: Cases were identified in the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network's Cesarean Registry with a woman with a twin pregnancy who had had at least 1 previous cesarean delivery. Results: During the study period (1999-2002), 412 women fulfilled the study criteria, and 226 women had elective repeat cesarean delivery. Of the 186 women (45.1{\%} of total) who attempted a trial of labor, 120 women were delivered successfully (success rate, 64.5{\%}), and 66 women (35.5{\%}) had a failed trial of labor. Thirty of the failed trials of labor involved a vaginal delivery for twin A and cesarean delivery for twin B. Women who attempted a trial of labor with twins had no increased risk of transfusion, endometritis, intensive care unit admissions, or uterine rupture when compared with elective repeat cesarean delivery. Fetal and neonatal complications were uncommon in either group at ≥34 weeks of gestation. Conclusion: A trial of labor with twins after previous cesarean delivery does not appear to increase maternal morbidity. Perinatal morbidity is uncommon at ≥34 weeks of gestation.",
keywords = "Previous cesarean delivery, Trial of labor, Twins",
author = "Varner, {Michael W.} and Sharon Leindecker and Spong, {Catherine Y.} and Moawad, {Atef H.} and Hauth, {John C.} and Landon, {Mark B.} and Leveno, {Kenneth J.} and Caritis, {Steve N.} and Margaret Harper and Wapner, {Ronald J.} and Yoram Sorokin and Menachem Miodovnik and Marshall Carpenter and Alan Peaceman and O'Sullivan, {Mary J.} and Sibai, {Baha M.} and Oded Langer and Thorp, {John M.} and Ramin, {Susan M.} and Mercer, {Brian M.} and Gabbe, {Steven G.}",
year = "2005",
month = "7",
day = "1",
doi = "10.1016/j.ajog.2005.03.023",
language = "English",
volume = "193",
pages = "135--140",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - The Maternal-Fetal Medicine Unit cesarean registry

T2 - Trial of labor with a twin gestation

AU - Varner, Michael W.

AU - Leindecker, Sharon

AU - Spong, Catherine Y.

AU - Moawad, Atef H.

AU - Hauth, John C.

AU - Landon, Mark B.

AU - Leveno, Kenneth J.

AU - Caritis, Steve N.

AU - Harper, Margaret

AU - Wapner, Ronald J.

AU - Sorokin, Yoram

AU - Miodovnik, Menachem

AU - Carpenter, Marshall

AU - Peaceman, Alan

AU - O'Sullivan, Mary J.

AU - Sibai, Baha M.

AU - Langer, Oded

AU - Thorp, John M.

AU - Ramin, Susan M.

AU - Mercer, Brian M.

AU - Gabbe, Steven G.

PY - 2005/7/1

Y1 - 2005/7/1

N2 - Objective: The purpose of this study was to identify the success rates and risks in women with a twin pregnancy who attempt a trial of labor after cesarean delivery. Study design: Cases were identified in the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network's Cesarean Registry with a woman with a twin pregnancy who had had at least 1 previous cesarean delivery. Results: During the study period (1999-2002), 412 women fulfilled the study criteria, and 226 women had elective repeat cesarean delivery. Of the 186 women (45.1% of total) who attempted a trial of labor, 120 women were delivered successfully (success rate, 64.5%), and 66 women (35.5%) had a failed trial of labor. Thirty of the failed trials of labor involved a vaginal delivery for twin A and cesarean delivery for twin B. Women who attempted a trial of labor with twins had no increased risk of transfusion, endometritis, intensive care unit admissions, or uterine rupture when compared with elective repeat cesarean delivery. Fetal and neonatal complications were uncommon in either group at ≥34 weeks of gestation. Conclusion: A trial of labor with twins after previous cesarean delivery does not appear to increase maternal morbidity. Perinatal morbidity is uncommon at ≥34 weeks of gestation.

AB - Objective: The purpose of this study was to identify the success rates and risks in women with a twin pregnancy who attempt a trial of labor after cesarean delivery. Study design: Cases were identified in the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network's Cesarean Registry with a woman with a twin pregnancy who had had at least 1 previous cesarean delivery. Results: During the study period (1999-2002), 412 women fulfilled the study criteria, and 226 women had elective repeat cesarean delivery. Of the 186 women (45.1% of total) who attempted a trial of labor, 120 women were delivered successfully (success rate, 64.5%), and 66 women (35.5%) had a failed trial of labor. Thirty of the failed trials of labor involved a vaginal delivery for twin A and cesarean delivery for twin B. Women who attempted a trial of labor with twins had no increased risk of transfusion, endometritis, intensive care unit admissions, or uterine rupture when compared with elective repeat cesarean delivery. Fetal and neonatal complications were uncommon in either group at ≥34 weeks of gestation. Conclusion: A trial of labor with twins after previous cesarean delivery does not appear to increase maternal morbidity. Perinatal morbidity is uncommon at ≥34 weeks of gestation.

KW - Previous cesarean delivery

KW - Trial of labor

KW - Twins

UR - http://www.scopus.com/inward/record.url?scp=22244465894&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=22244465894&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2005.03.023

DO - 10.1016/j.ajog.2005.03.023

M3 - Article

C2 - 16021071

AN - SCOPUS:22244465894

VL - 193

SP - 135

EP - 140

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 1

ER -