With Appropriate Selection, Trial of Labor for Twin Birth Is Safe

Twin pregnancy rates continue to rise; however, consensus about the safest delivery mode is lacking. Researchers in Ireland conducted a prospective multicenter study to determine predictors of successful vaginal twin birth and to assess perinatal morbidity in relation to delivery mode (elective cesarean delivery, prelabor emergency cesarean delivery, or trial of labor) in a cohort of 971 women with twin pregnancies. A composite measure of adverse perinatal outcomes was analyzed according to mode of delivery.

Cesarean delivery was planned in 430 women, and emergent prelabor cesarean delivery was performed in 100 women. Trial of labor was attempted by 441 women, 338 of whom (77%) were successful. Vaginal breech extraction was required for the …