Is the protocol for induction of labor in singletons applicable to twin gestations?
Michael D Wolfe1, Lesley de la Torre, Lisa E Moore
1Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC 10 5580, 1 University of New Mexico, Albuquerque, NM 87131, USA.
Objective:
To evaluate the success of induction of labor in twin gestations using standard protocols for misoprostol and oxytocin designed for singleton gestations.
Study Design:
This retrospective cohort study involved all diamniotic twin gestations that were induced at > or = 32 weeks' gestation with intact membranes. Two singleton pregnancies were matched for each twin pregnancy. Use of intravaginal misoprostol and low-dose intravenous oxytocin was based on ACOG management guidelines.
Results:
A small proportion (40 of 430 [9.3%]) of twins met the inclusion criteria for an induction of labor. Misoprostol was utilized less frequently with twins than with singletons (55% vs. 78%, p = 0.02) because of the higher preinduction Bishop score. Doses of oxytocin were comparable between the 2 groups. A high rate of vaginal delivery was seen in the twin and singleton groups (85.0% vs. 80.0%, p = 0.62) with similar neonatal outcomes.
Conclusion:
A standard protocol of labor induction for singleton gestations would apply for twins with overall favorable intrapartum outcomes.
Related Concept Videos
Intrauterine Drug Delivery Systems
Ovarian Cycle
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

