Comparison of active phase labor between triplet, twin, and singleton 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.