{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T23:27:04Z","timestamp":1783639624238,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:00:00Z","timestamp":1558569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To perform a systematic review of success rates of trial of labor after cesarean (TOLAC) and maternal and neonatal outcomes in twin pregnancy versus\u00a0elective repeat cesarean delivery (ERCD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched MEDLINE, EMBASE, and Web of Science from data inception to May 2018 with no language or regional restrictions, to identify all studies that compared twin TOLAC and ERCD for maternal and\/or neonatal outcomes. The Newcastle\u2010Ottawa Scale was used to assess the methodological quality of the included studies. We assessed the pooled relative risk and mean difference using a random\u2010effects model. The pooled event rates for successful VBAC, cesarean delivery\u00a0for twin B after vaginal delivery of twin A, and uterine rupture were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 841 citations identified, 10 were eligible for analysis (2336 TOLAC cases and 5763 ERCD cases). The pooled event rates for successful VBAC and uterine rupture during TOLAC were 72.2% (95% CI 59.7%\u201083.2%) and 0.87% (95% CI 0.51%\u20101.31%), respectively. TOLAC was associated with a significantly higher risk of neonatal death (RR 3.02 [95% CI 1.07\u20108.54])\u00a0with no significant differences in mean gestational age at birth, NICU admission rates, or 5\u2010minute Apgar &lt;7. Although the risk for maternal infectious morbidity was significantly lower with TOLAC\u00a0(RR 0.48 [95% CI 0.25\u20100.90]), risks of uterine dehiscence, blood transfusions, and hysterectomy were comparable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Twin TOLAC is associated with a relatively high rate of successful vaginal delivery and a low risk of uterine rupture. The finding of higher neonatal\u00a0mortality rates may be influenced by prematurity, but requires further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12434","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T02:23:27Z","timestamp":1558664607000},"page":"550-559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Trial of labor versus elective repeat cesarean delivery in twin pregnancies after a previous cesarean delivery\u2014A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-4846","authenticated-orcid":false,"given":"Shiri","family":"Shinar","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Michael\u2032s Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haroon","family":"Hasan","sequence":"additional","affiliation":[{"name":"Epi Methods Consulting Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Michael\u2032s Hospital Toronto Ontario Canada"},{"name":"Keenan Research Centre for Biomedical Science of St. Michael\u2032s Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,23]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"MartinJA HamiltonBE OstermanM.Births in the United States 2016. 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