Should we deliver twins electively at 37 weeks' gestation?
Jodie M Dodd1, Caroline A Crowther
1Department of Obstetrics and Gynaecology, University of Adelaide, South Australia. jodie.dodd@adelaide.edu.au
Current Opinion in Obstetrics & Gynecology
|November 1, 2005
Summary
Elective delivery of twins at 37 weeks gestation may reduce risks, but more randomized controlled trials are needed. Current evidence is insufficient to confirm benefits outweigh potential harms for mother and infant.
Area of Science:
- Maternal-Fetal Medicine
- Obstetrics
- Perinatology
Background:
- Twin gestations are associated with increased risks of perinatal morbidity and mortality.
- Determining optimal timing for delivery in twin pregnancies is crucial for improving outcomes.
Purpose of the Study:
- To review existing literature and assess the evidence for elective twin delivery at 37 weeks' gestation.
- To answer the clinical question regarding the safety and efficacy of delivering twins electively at 37 weeks.
Main Methods:
- Systematic review of available literature.
- Analysis of retrospective studies and a single randomized controlled trial.
Main Results:
- Retrospective data suggest lowest perinatal risks for twins at 37 weeks' gestation.
- A limited randomized trial compared elective delivery with expectant management.
- Insufficient randomized controlled trial data exist to definitively weigh benefits against harms.
Conclusions:
- Elective delivery at 37 weeks may reduce twin perinatal mortality and morbidity.
- Further high-quality randomized controlled trials are necessary to establish definitive recommendations for elective twin delivery at 37 weeks' gestation.
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