{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T03:21:39Z","timestamp":1772767299739,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T00:00:00Z","timestamp":1490313600000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The main aims of this study were to compare maternal and neonatal outcomes in term twin birth according to the planned mode of delivery and to study the effects of chorionicity and inter\u2010twin delivery time on neonatal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A single\u2010center cohort study of 495 women with twin deliveries at \u226537<jats:sup>+0<\/jats:sup> weeks of gestation. Term twin deliveries were divided into a trial of labor group (<jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content>, 69.3%) and a planned cesarean section (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>) group (30.7%). The primary outcomes were maternal and neonatal morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>80.8% of women attempting <jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content> achieved vaginal birth. In the <jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content> group, mothers had less bleeding [median 500 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> (range 150\u20132700 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>) vs. 950 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> (range 150\u20133500 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>), <jats:italic>p<\/jats:italic> &lt; 0.001) and fewer surgical complications (3.2% vs. 8.6%, <jats:italic>p<\/jats:italic> = 0.011), whereas second twins more often had five\u2010minute Apgar scores of &lt;7 (5.0% vs. 0%, <jats:italic>p<\/jats:italic> = 0.002) or umbilical artery <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> &lt; 7.05 (5.7% vs. 0%, <jats:italic>p<\/jats:italic> = 0.003), compared with the planned <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> group. There was a slight, non\u2010significant tendency for more <jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content> admissions in the <jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content> group, yet the need for <jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content> treatment was infrequent in the whole study material. Outcomes among dichorionic (<jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content>) second twins were similar to those in the whole material, but among monochorionic (<jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content>) second twins there were no differences between the <jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content> and planned <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> groups. In secondary analysis, a five\u2010minute Apgar score &lt;7 occurred significantly more often in the <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> group among second twins if the inter\u2010twin delivery time exceeded 30 min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content> is a good option for women with twin pregnancy at term, regardless of chorionicity. Active management of labor for the second twin is important, also in <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> births. Maternal outcomes were more favorable with <jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content> and although low Apgar scores and low umbilical blood <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> may be more frequent after <jats:styled-content style=\"fixed-case\">TOL<\/jats:styled-content> \u2013 especially with the second twin \u2013 serious neonatal morbidity is rare and does not differ from that after planned <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13122","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T10:46:41Z","timestamp":1488192401000},"page":"589-596","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Term twin birth \u2013 impact of mode of delivery on outcome"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9547-8733","authenticated-orcid":false,"given":"Elina","family":"Ylilehto","sequence":"first","affiliation":[{"name":"School of Medicine University of Tampere Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0161-7486","authenticated-orcid":false,"given":"Outi","family":"Palom\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[{"name":"School of Health Sciences University of Tampere Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukka","family":"Uotila","sequence":"additional","affiliation":[{"name":"School of Medicine University of Tampere Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,24]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"VuoriE GisslerM.Perinatal statistics: parturients deliveries and newborns 2014.Helsinki Finland:National Institute for Health and Welfare 2015. Available from:https:\/\/www.julkari.fi\/handle\/10024\/126971(accessed September 30 2015)."},{"key":"e_1_2_8_3_1","first-page":"1","article-title":"Births: final data for 2014","volume":"64","author":"Hamilton BE","year":"2015","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_8_4_1","first-page":"618","article-title":"The epidemiology of perinatal mortality in multiple births","volume":"66","author":"Kiely JL","year":"1990","journal-title":"Bull N Y Acad Med"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2012.02.004"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01556.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.11.002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10057"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(00)70233-X"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2008.08.019"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.64"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02836.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000227747.37184.0a"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00631.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01356.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.733752"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12558"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2014-0072"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000105"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214939"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-71"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2006.03.002"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1471"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2002.01159.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.079"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610600963929"},{"key":"e_1_2_8_27_1","first-page":"502","article-title":"Multiple gestation: time interval between delivery of the first and second twins","volume":"63","author":"Rayburn WF","year":"1984","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349.2010.487893"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12642"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.13122","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T04:59:21Z","timestamp":1696481961000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,24]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1111\/aogs.13122"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13122","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,24]]},"assertion":[{"value":"2016-11-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}