Obstet Gynecol Sci.  2019 Nov;62(6):404-410. 10.5468/ogs.2019.62.6.404.

Outcomes of ‘one-day trial of vaginal delivery of twins’ at 36–37 weeks' gestation in Japan

• Haruna Y
• Suzuki S

• KMID: 2462118
• DOI: http://doi.org/10.5468/ogs.2019.62.6.404

Abstract

OBJECTIVE
The lack of obstetricians in Japan has prevented the implementation of a 24-hour delivery monitoring system for high-risk deliveries such as twin vaginal delivery at many obstetric facilities. To examine the outcomes of a 1-day trial of the vaginal delivery of twins at 36-37 weeks' gestation.
METHODS
We induced the vaginal delivery of twins at 36-37 weeks' gestation of 256 women who provided consent between January 2007 and December 2016 using the following protocol: 1) administration of 0.5 mg oral prostaglandin E2 every 1 hour (maximum: 1.5 mg) in the morning; 2) intravenous administration of oxytocin and amniotomy in the afternoon; and 3) selection of caesarean delivery when vaginal delivery was not expected by evening. We examined their perinatal outcomes in a chart review.
RESULTS
The completion rates of vaginal delivery in total, nulliparous, and multiparous women were 79%, 72%, and 84%, respectively. There were no cases of neonatal asphyxia. The total incidence of neonatal respiratory disorders was 2.1%, but there were no cases of persistent pulmonary hypertension. The total incidence of postpartum hemorrhage requiring transfusion was 2.7%.
CONCLUSION
The 1-day planned vaginal delivery of twins at 36-37 weeks' gestation appears valid and safe, and our findings suggest that it can be an option for the delivery of twins.

Keyword

Twin pregnancy; Trial of labor; Perinatal outcomes

MeSH Terms

Administration, Intravenous
Asphyxia
Dinoprostone
Female
Humans
Hypertension, Pulmonary
Incidence
Japan*
Oxytocin
Postpartum Hemorrhage
Pregnancy*
Pregnancy, Twin
Trial of Labor
Twins
Dinoprostone
Oxytocin

Figure

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  Fig. 1 Flow diagram of the study.

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