According to Health Day News on Wednesday, a new study suggests that obstetricians shouldn't rule out the possibility of vaginal birth for twins.
In the hands of an experienced obstetrician, there are no differences in serious adverse events for babies or their mothers, the study, published in the October issue of New England Journal of Medicine, found.
Twins account for about 33 of every 1,000 births in the United States, according to the U.S. Centers for Disease Control and Prevention. The number of twin pregnancies has risen dramatically since the 1980s and 1990s because of assisted reproductive technologies.
The rate of cesarean delivery of twins has also increased, doubling that of the WHO recommendation for the national average of cesarean deliveries. To find out if cesarean birth offered any advantages over a planned vaginal delivery, study author Jon Barrett and his colleagues recruited about 2,800 pregnant women from 25 countries. All were between 32 weeks and 38 weeks 6 days of gestation.
The rate of cesarean delivery was 91 percent in the planned cesarean group. For women assigned to the planned vaginal delivery group, 56.2 percent delivered both twins vaginally, and 4.2 percent had a combined vaginal-cesarean delivery. Forty percent of those planning a vaginal birth ended up having a cesarean-section, according to the report.
The women and babies were followed for 28 days after the birth to monitor for serious adverse outcomes, such as death or a serious problem with the baby, including spinal cord injury or signs of lung problems, according to the study. The researchers also looked for serious adverse events in the mothers.
No difference was noted in the rate of serious adverse outcomes for babies or mothers between the two groups, the study authors noted.
However, some experts feel that this study will not lead to a change in clinical practice, at least not in the United States.
Barrett and Greene said that women carrying twins who want to try to deliver vaginally need to make sure their obstetrician is experienced in delivering twins vaginally.
"Realize that you have a choice, and find a center or an obstetrician who is willing to [honor] your choice. If they can't offer vaginal delivery in their hospital, they should refer you to a center that can, rather than just diverting you to a cesarean delivery," said Barrett.
Emily Sutherlin is also the Top News Examiner.
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