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Progression of labor in twin versus singleton gestations
E Schiff1, S B Cohen, M Dulitzky
1Departments of Obstetrics and Gynecology and Epidemiology, Sheba Medical Center, Oregon Health Sciences University, Portland, Oregon, USA.
American Journal of Obstetrics and Gynecology
|November 20, 1998
Summary
Twin gestations show a significantly shorter first stage of labor compared to singleton gestations. This finding suggests different labor management strategies may be needed for twin pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatal Research
Background:
- Labor progression in twin gestations is not well-defined.
- Understanding differences in labor curves can optimize delivery management.
Purpose of the Study:
- To compare labor curves between twin and singleton gestations.
- To identify potential differences in the stages of labor.
Main Methods:
- Retrospective analysis of 1821 twin deliveries and matched singleton controls.
- Exclusion criteria included labor induction, augmentation, and specific maternal/fetal conditions.
- Kaplan-Meier survival analysis was used to compare labor stages.
Main Results:
- Twin gestations had a significantly shorter first stage of labor (3.0 vs. 4.0 hours, P <.0001).
- This difference was primarily observed in nulliparous women.
- No significant difference was found in the second stage of labor.
Conclusions:
- Twin gestations exhibit a shorter first stage of labor compared to singletons.
- Lower presenting twin birth weight or altered uterine contractility may contribute to this difference.
- Distinct labor curves should be considered for managing twin deliveries.