title: Vaginal birth after cesarean section in twin gestation.
abstract: OBJECTIVE
  We report a 10-year experience with vaginal birth after cesarean section in women with twins.
  
  
  METHODS
  Data were gathered from labor and delivery records and maternal and neonatal hospital charts. Women with a vertical uterine scar, a previous uterine rupture, an unrepaired dehiscence, or obstetric contraindications to labor were excluded from a trial of labor. Full-thickness uterine defects requiring intervention were classified as ruptures; all others were classified as dehiscences.
  
  
  RESULTS
  Between Jan. 1, 1985, and Dec. 31, 1994, at Los Angeles County/University of Southern California Women's Hospital, 210 women with previous cesarean births were delivered of twins. One hundred eighteen (56%) underwent repeat cesarean delivery without a trial of labor. Ninety-two (44%) undertook a trial of labor with no uterine ruptures and no increase in maternal or perinatal morbidity or mortality.
  
  
  CONCLUSIONS
  In women with twins a trial of labor after a previous cesarean section is a safe and effective alternative to routine repeat cesarean delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Los Angeles County/University of Southern California Women's and Children's Hospital 90033, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Miller
authors.forename: P
authors.initials: P
authors.lastname: Mullin
authors.forename: D
authors.initials: D
authors.lastname: Hou
authors.forename: R H
authors.initials: RH
authors.lastname: Paul
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors; D014427:Twins; D016064:Vaginal Birth after Cesarean