Risk factors for cesarean delivery in twin gestations near term

William A Grobman*, Sharon L Dooley, Alan M Peaceman

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: We evaluated the risk factors associated with cesarean delivery in laboring twin gestations at least 36 completed weeks. Methods: We reviewed the records of 134 women with twin gestations who underwent a trial of labor between 1993 and 1995. Women who delivered by cesarean were compared with women who delivered vaginally. The factors associated with an increased risk for cesarean were determined using univariate analysis. Logistic regression was used to determine which of those factors was most strongly associated with cesarean delivery. Results: Of 134 laboring twin gestations, 25 (18.7%) delivered by cesarean and 109 (81.3%) delivered vaginally. Univariate analysis revealed that women who delivered by cesarean were more likely to be nulliparous, have a less advanced cervix at both admission and epidural placement, a higher mean oxytocin infusion rate for induction or augmentation of labor, a combined fetal weight greater than 5500 g, and received magnesium for seizure prophylaxis. Multivariate analysis identified that nulliparity and timing of epidural administration were the factors most strongly associated with cesarean delivery. Conclusion: The timing of epidural analgesia is a modifiable risk factor strongly associated with cesarean delivery in term and near-term laboring twin gestations.

Original languageEnglish (US)
Pages (from-to)940-944
Number of pages5
JournalObstetrics and Gynecology
Volume92
Issue number6
DOIs
StatePublished - Dec 1 1998

Fingerprint

Pregnancy
Trial of Labor
Fetal Weight
Epidural Analgesia
Oxytocin
Parity
Cervix Uteri
Magnesium
Seizures
Multivariate Analysis
Logistic Models

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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abstract = "Objective: We evaluated the risk factors associated with cesarean delivery in laboring twin gestations at least 36 completed weeks. Methods: We reviewed the records of 134 women with twin gestations who underwent a trial of labor between 1993 and 1995. Women who delivered by cesarean were compared with women who delivered vaginally. The factors associated with an increased risk for cesarean were determined using univariate analysis. Logistic regression was used to determine which of those factors was most strongly associated with cesarean delivery. Results: Of 134 laboring twin gestations, 25 (18.7{\%}) delivered by cesarean and 109 (81.3{\%}) delivered vaginally. Univariate analysis revealed that women who delivered by cesarean were more likely to be nulliparous, have a less advanced cervix at both admission and epidural placement, a higher mean oxytocin infusion rate for induction or augmentation of labor, a combined fetal weight greater than 5500 g, and received magnesium for seizure prophylaxis. Multivariate analysis identified that nulliparity and timing of epidural administration were the factors most strongly associated with cesarean delivery. Conclusion: The timing of epidural analgesia is a modifiable risk factor strongly associated with cesarean delivery in term and near-term laboring twin gestations.",
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Risk factors for cesarean delivery in twin gestations near term. / Grobman, William A; Dooley, Sharon L; Peaceman, Alan M.

In: Obstetrics and Gynecology, Vol. 92, No. 6, 01.12.1998, p. 940-944.

Research output: Contribution to journalArticle

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