{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T19:55:30Z","timestamp":1781812530724,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates whether timing of amniotomy affects labor characteristics and maternal and neonatal outcomes in twin deliveries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study was conducted at a single academic medical center and included dichorionic diamniotic (DCDA) twin pregnancies with a normal anomaly scan and a vertex\u2010presenting leading twin, delivered over a 7\u2010year period. The cohort was divided into two groups: early amniotomy (performed at cervical dilation \u22643\u2009cm) and late amniotomy (performed at &gt;3\u2009cm cervical dilation). Exclusion criteria included monochorionic twin pregnancies and planned elective cesarean deliveries. Maternal demographics, delivery characteristics, and neonatal outcomes were compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 51\u2009592 deliveries, 1196 were twins; 565 DCDA pregnancies met the inclusion criteria (early\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009279; late\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009286). Groups were similar in age, body mass index (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), comorbidities, and gestation. Nulliparity and intrapartum cesarean rates were more common in the early amniotomy group (56.6% vs. 29.4%;\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.001, 24.4% vs. 9.8%;\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.001, respectively). Induction and augmentation rates, rupture\u2010to\u2010delivery interval, second stage duration, intrapartum fever, and meconium were similar. Neonatal outcomes, including birthweight, 5\u2010min Apgar &lt;7, neonatal intensive care unit admission, and composite morbidity were comparable. On adjusted analysis, early amniotomy (adjusted odds ratio [aOR] 1.84; 95% confidence interval 1.09\u20133.1), nulliparity (aOR 5.60; 3.17\u20139.87), and previous cesarean (aOR 3.94; 1.32\u201311.77) increased cesarean risk, whereas epidural was protective (aOR 0.40; 0.24\u20130.67).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In DCDA twin labor, early amniotomy (\u22643\u2009cm) is associated with increased intrapartum cesarean, despite similar durations of labor and neonatal outcomes. Amniotomy timing should be individualized, with caution against routine early rupture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70803","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T08:37:31Z","timestamp":1768379851000},"page":"152-160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early versus late amniotomy during twin labor"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6461-3557","authenticated-orcid":false,"given":"Or","family":"Eliner","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Meir Medical Center  Kfar Saba Israel"},{"name":"Gray Faculty of Medical and Health Science Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inbar","family":"Lidor","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and 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