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[Twin delivery after cesarean section: is a trial of labor warranted?]
A Aboulfalah1, H Abbassi, M el Karroumi
1Maternité Lalla Meryem, CHU Ibn Rochd, Casablanca, Maroc.
Objective:
To determine whether a trial of labor in twin pregnancy is a valuable alternative to routine repeat cesarean section.
Material And Methods:
Based on retrospective analysis of 31 cases of twin gestation with previous cesarean section, we tried to assess the outcomes of 25 cases of trial of labor. The outcomes of trial of labor in twin pregnancy were compared to those of trial of labor in singleton pregnancy.
Results:
The trial of labor was successful in 21 cases (84%). There was one case of scar dehiscence among the women who underwent a trial of labor, that occurred in the parturient with two previous cesarean sections after complete breech extraction. There were no significant differences in perinatal outcomes in any comparison of trial of labor versus no trial of labor. The outcomes of trial of labor in the twin pregnancy were similar to singleton pregnancy.
Conclusions:
Routine repeat cesarean section in the twin pregnancy is not necessarily warranted; a controlled trial of labor in selected cases would be a valuable alternative.