Format

Send to

Choose Destination
Am J Obstet Gynecol. 2013 Sep;209(3):254.e1-5. doi: 10.1016/j.ajog.2013.06.019. Epub 2013 Jul 17.

Labor patterns in twin gestations.

Author information

1
Division of Maternal-Fetal Medicine, University of Illinois at Chicago, Chicago, IL, USA.

Abstract

OBJECTIVE:

To compare labor progression in twin vs singleton gestations.

STUDY DESIGN:

Retrospective review of electronic database created by Consortium on Safe Labor, reflecting labor and delivery information from 12 clinical centers 2002-2008. Women with twin gestations, cephalic presentation of presenting twin, gestational age ≥34 weeks, with ≥2 cervical examinations were included. Exclusion criteria were fetal anomalies or demise. Singleton controls were selected by the same criteria. Categorical variables were analyzed by χ(2); continuous by Student t test. Interval censored regression was used to determine distribution for time of cervical dilation in centimeters, or "traverse times," and controlled for confounding factors. Repeated-measures analysis constructed mean labor curves by parity and number of fetuses.

RESULTS:

A total of 891 twin gestations were compared with 100,513 singleton controls. Twin gestations were more often older, white or African American, earlier gestational age, increased prepregnancy body mass index, and with lower birthweight. There was no difference in number of prior cesarean deliveries, induction, or augmentation, or epidural use. Median traverse times increased at every centimeter interval in nulliparous twins, in both unadjusted and adjusted analysis (P < .01). A similar pattern was noted for multiparas in both analyses. Labor curves demonstrated a delayed inflection point in the labor pattern for nulliparous and multiparous twin gestations.

CONCLUSION:

Both nulliparous and multiparous women have slower progression of active phase labor with twins even when controlling for confounding factors.

KEYWORDS:

labor curves; pregnancy; twins

PMID:
23871795
PMCID:
PMC3940309
DOI:
10.1016/j.ajog.2013.06.019
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center