Outcomes of ‘one-day trial of vaginal delivery of twins’ at 36–37 weeks’ gestation in Japan
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ObjectiveThe lack of obstetricians in Japan has prevented the implementation of a 24–hour delivery monitoring system forhigh-risk deliveries such as twin vaginal delivery at many obstetric facilities. To examine the outcomes of a 1-day trialof the vaginal delivery of twins at 36–37 weeks’ gestation. MethodsWe induced the vaginal delivery of twins at 36–37 weeks’ gestation of 256 women who provided consent betweenJanuary 2007 and December 2016 using the following protocol: 1) administration of 0.5 mg oral prostaglandin E2every 1 hour (maximum: 1.5 mg) in the morning; 2) intravenous administration of oxytocin and amniotomy in theafternoon; and 3) selection of caesarean delivery when vaginal delivery was not expected by evening. We examinedtheir perinatal outcomes in a chart review. ResultsThe completion rates of vaginal delivery in total, nulliparous, and multiparous women were 79%, 72%, and 84%,respectively. There were no cases of neonatal asphyxia. The total incidence of neonatal respiratory disorders was2.1%, but there were no cases of persistent pulmonary hypertension. The total incidence of postpartum hemorrhagerequiring transfusion was 2.7%. ConclusionThe 1-day planned vaginal delivery of twins at 36–37 weeks’ gestation appears valid and safe, and our findingssuggest that it can be an option for the delivery of twins.
Abstract
ObjectiveThe lack of obstetricians in Japan has prevented the implementation of a 24–hour delivery monitoring system forhigh-risk deliveries such as twin vaginal delivery at many obstetric facilities. To examine the outcomes of a 1-day trialof the vaginal delivery of twins at 36–37 weeks’ gestation. MethodsWe induced the vaginal delivery of twins at 36–37 weeks’ gestation of 256 women who provided consent betweenJanuary 2007 and December 2016 using the following protocol: 1) administration of 0.5 mg oral prostaglandin E2every 1 hour (maximum: 1.5 mg) in the morning; 2) intravenous administration of oxytocin and amniotomy in theafternoon; and 3) selection of caesarean delivery when vaginal delivery was not expected by evening. We examinedtheir perinatal outcomes in a chart review. ResultsThe completion rates of vaginal delivery in total, nulliparous, and multiparous women were 79%, 72%, and 84%,respectively. There were no cases of neonatal asphyxia. The total incidence of neonatal respiratory disorders was2.1%, but there were no cases of persistent pulmonary hypertension. The total incidence of postpartum hemorrhagerequiring transfusion was 2.7%. ConclusionThe 1-day planned vaginal delivery of twins at 36–37 weeks’ gestation appears valid and safe, and our findingssuggest that it can be an option for the delivery of twins.
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