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Comparison of active phase labor between triplet, twin, and singleton gestations
R K Silver1, E I Haney, W A Grobman
1Division of Maternal-Fetal Medicine, Evanston & Prentice Womens' Hospitals, Northwestern University Medical School, Chicago, Illinois, USA. r-silver@nwu.edu
Journal of the Society for Gynecologic Investigation
|October 18, 2000
Summary
Active labor in triplet and twin pregnancies progresses slower than in singletons. This slower cervical dilation rate is linked to higher total fetal weight in multiple gestations.
Area of Science:
- Maternal-Fetal Medicine
- Obstetrics
- Perinatology
Background:
- Labor progression varies significantly with gestational status.
- Understanding active labor dynamics in multiple gestations is crucial for clinical management.
Purpose of the Study:
- To characterize the active phase of labor in triplet pregnancies.
- To compare labor progression in triplets with gestational age-matched twins and singletons.
Main Methods:
- Calculated active phase dilation rates (cm/hour) from 5 cm for women with triplet gestations (>24 weeks).
- Matched triplet, twin, and singleton cohorts for gestational age, parity, and epidural use.
- Analyzed intrapartum variables including oxytocin use and cervical dilation at membrane rupture.
Main Results:
- Triplet and twin active phase dilation rates (1.8 and 1.7 cm/hour) were significantly slower than singletons (2.3 cm/hour).
- Mean birth weights were lower in triplets (1,968g) and twins (2,112g) compared to singletons (2,493g).
- A significant inverse correlation was found between active phase dilation rate and cumulative birth weight per pregnancy (R = -0.24, P = 0.002).
Conclusions:
- Active phase cervical dilation is slower in triplet and twin pregnancies compared to singletons.
- Increased total fetal weight in multiple gestations is associated with slower labor progression.