{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:23:01Z","timestamp":1790036581195,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,2,28]],"date-time":"2014-02-28T00:00:00Z","timestamp":1393545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare maternal and neonatal outcomes in twins undergoing a trial of labor versus pre\u2010labor caesarean.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>19 <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> hospitals from the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>onsortium on <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>afe <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>abor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Of 2225 twin sets \u226536\u00a0weeks' gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Maternal (abruption, estimated blood loss, postpartum haemorrhage, transfusion, chorioamnionitis, hysterectomy, <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> admission, death) and neonatal outcomes (birth injury, 5\u2010minute Apgar &lt;7, <jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content> admission, <jats:styled-content style=\"fixed-case\">RDS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> TTN<\/jats:styled-content>, sepsis, asphyxia, <jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content> length of stay, death) were compared between the trial of labour and pre\u2010labour caesarean groups with univariate and multivariate logistic and linear regression analyses. Similar analyses were performed for actual delivery modes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Maternal and neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 2225 twin sets, 1078 had a trial of labour, and 65.9% of those delivered vaginally. There was an increased risk for postpartum haemorrhage [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.5, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.4\u20134.5] and blood transfusion (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.9, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.2\u20133.2) for the trial of labour compared with pre\u2010labour caesarean groups. Birth injury only occurred in the trial of labour group, 1% Twin A, 0.4% Twin B. Both twins had a higher risk of 5\u2010minute Apgar &lt;7 with trial of labour compared to pre\u2010labour caesarean (A: <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.9, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.05\u201314.5; B: <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.9, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.3\u201312.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Term twins undergoing a trial of labour have increased maternal haemorrhage and transfusions along with neonatal birth trauma and lower <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>pgar scores, but these absolute neonatal occurrences were rare. Trial of labour in twins remains a safe and reasonable option in appropriately selected cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12642","type":"journal-article","created":{"date-parts":[[2014,2,28]],"date-time":"2014-02-28T07:43:26Z","timestamp":1393573406000},"page":"1137-1144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The effects of labor and delivery on maternal and neonatal outcomes in term twins: a retrospective cohort study"],"prefix":"10.1111","volume":"121","author":[{"given":"DJ","family":"Wenckus","sequence":"first","affiliation":[{"name":"Division of Maternal Fetal Medicine Department of Obstetrics and Gynecology University of Illinois at Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Gao","sequence":"additional","affiliation":[{"name":"Center for Clinical and Translational Science University of Illinois at Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MA","family":"Kominiarek","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Department of Obstetrics and Gynecology University of Illinois at Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Wilkins","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine Department of Obstetrics and Gynecology University of Illinois at Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200410000-00046"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182318651"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.11.029"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000233154.62729.24"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000206182.63788.80"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000219750.79480.84"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)76016-5"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050410001668707"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.05.013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.02.007"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.64"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90201-8"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000227747.37184.0a"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00631.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.09.132"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211408"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181c8b462"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318163c435"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181fdef6e"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.058"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.05.033"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.12.009"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000110248.32558.fb"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.06.084"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.03.023"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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