Outcomes of ‘one-day trial of vaginal delivery of twins’ at 36–37 weeks' gestation in Japan
10.5468/ogs.2019.62.6.404
- Author:
Yuria HARUNA
1
;
Shunji SUZUKI
Author Information
1. Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan. czg83542@mopera.ne.jp
- Publication Type:Original Article
- Keywords:
Twin pregnancy;
Trial of labor;
Perinatal outcomes
- MeSH:
Administration, Intravenous;
Asphyxia;
Dinoprostone;
Female;
Humans;
Hypertension, Pulmonary;
Incidence;
Japan;
Oxytocin;
Postpartum Hemorrhage;
Pregnancy;
Pregnancy, Twin;
Trial of Labor;
Twins
- From:Obstetrics & Gynecology Science
2019;62(6):404-410
- CountryRepublic of Korea
- Language:English
-
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.
