TY - JOUR
T1 - Vaginal birth after cesarean (VBAC) attempt in twin pregnancies
T2 - Is it safe?
AU - Cahill, Alison
AU - Stamilio, David M.
AU - Paré, Emmanuelle
AU - Peipert, Jeffrey P.
AU - Stevens, Erika J.
AU - Nelson, Deborah B.
AU - Macones, George A.
N1 - Funding Information:
This work was supported by a grant from NICHD (RO1 HD 35631 to G. A. M.). Dr Macones is a recipient of a K24 grant from NICHD (K24 HD01289), which partially supports this work. Dr Peipert is a recipient of a K24 grant from NICHD (K24 HD01298), which partially supports this work.
PY - 2005/9
Y1 - 2005/9
N2 - Objective: The purpose of this study was to compare the rate of vaginal birth after cesarean (VBAC) attempt, VBAC failure, and major maternal adverse outcomes in women with a previous cesarean with twin or singleton pregnancies. Study design: This was a multicenter retrospective cohort study between the years 1996 and 2000. Subjects were identified by ICD-9 code. Trained research nurses collected medical record data on the outcome of VBAC attempts, and clinical outcomes, including uterine rupture and major operative injuries. We used bivariate and multivariable techniques to assess the association between twins and the outcomes. Results: Of 25,005 patients with at least 1 previous cesarean, there were 535 twin pregnancies and 24,307 singleton pregnancies. Compared with patients with singleton gestations, patients with twins were less likely to attempt a VBAC (adjusted odds ratio [AOR] 0.3, 95% CI 0.2-0.4), but no more likely to have a VBAC failure (AOR 1.1, 95% CI 0.8-1.6), a uterine rupture (AOR 1.2, 95% CI 0.3-4.6), or a major maternal morbidity (AOR 1.6, 95% CI 0.7-3.7). Conclusion: Women with twin gestations are less likely to attempt a VBAC, but they are no more likely to fail a VBAC trial or experience a major morbid event compared with women with singleton gestations.
AB - Objective: The purpose of this study was to compare the rate of vaginal birth after cesarean (VBAC) attempt, VBAC failure, and major maternal adverse outcomes in women with a previous cesarean with twin or singleton pregnancies. Study design: This was a multicenter retrospective cohort study between the years 1996 and 2000. Subjects were identified by ICD-9 code. Trained research nurses collected medical record data on the outcome of VBAC attempts, and clinical outcomes, including uterine rupture and major operative injuries. We used bivariate and multivariable techniques to assess the association between twins and the outcomes. Results: Of 25,005 patients with at least 1 previous cesarean, there were 535 twin pregnancies and 24,307 singleton pregnancies. Compared with patients with singleton gestations, patients with twins were less likely to attempt a VBAC (adjusted odds ratio [AOR] 0.3, 95% CI 0.2-0.4), but no more likely to have a VBAC failure (AOR 1.1, 95% CI 0.8-1.6), a uterine rupture (AOR 1.2, 95% CI 0.3-4.6), or a major maternal morbidity (AOR 1.6, 95% CI 0.7-3.7). Conclusion: Women with twin gestations are less likely to attempt a VBAC, but they are no more likely to fail a VBAC trial or experience a major morbid event compared with women with singleton gestations.
KW - Cesarean delivery
KW - Twins
KW - Vaginal birth
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U2 - 10.1016/j.ajog.2005.06.038
DO - 10.1016/j.ajog.2005.06.038
M3 - Article
C2 - 16157110
AN - SCOPUS:24644462750
SN - 0002-9378
VL - 193
SP - 1050
EP - 1055
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 3 SUPPL.
ER -