DALLAS Oct. 29, 2008 Doctors need not go straight to Caesarean section when delivering twins, but can start with vaginal delivery of the first twin in many cases, researchers have found in a study led by UT Southwestern Medical Center.
Should the second-born twin turn out to require a Caesarean section, there is a slightly higher risk of infection for the baby and the mother, but that is easily treated and the risk of more serious complications for the second twin is not increased, the researchers found.
"It keeps the options open for women and providers who are motivated for vaginal delivery," said Dr. James Alexander, associate professor of obstetrics and gynecology at UT Southwestern and lead author of the two-year study, which appears in the October issue of the journal Obstetrics and Gynecology.
Although such "combined" delivery is relatively rare, there have been no large-scale studies to gauge how the mothers and babies fared after the procedure, Dr. Alexander said.
The UT Southwestern researchers are members of the Maternal-Fetal Medicine Units Network, a subset of the National Institutes of Health that comprises 14 university-based clinical centers and a data coordinating center.
They compared deliveries of 1,028 women at 13 network locations from 1999 to 2000, using data collected from a registry of information maintained by the group. This made the study the largest to address the question of combined-delivery safety, Dr. Alexander said.
All of the women in the study went through a period of labor. Ultimately, 849 had Caesarean sections of both twins, while 179 had a combined delivery of the first twin vaginally and the second by Caesarean section, usually because of a nonreassuring fetal heart rate or a poor position for delivery.
Four percent of women who had combined delivery developed chorioamnionitis, an infection involving the uterus, while 13 percent developed endomet
|Contact: Aline McKenzie|
UT Southwestern Medical Center