title: Induction of labor in twin pregnancy after 36 weeks does not increase maternal-fetal morbidity.
abstract: OBJECTIVE
  To compare maternal and perinatal outcomes in twin pregnancy patients without any fetal or maternal disease, managed by labor induction or expectant management after 36 weeks gestation.
  
  
  METHODS
  We conducted a case-control study of 81 patients: labor induction (n=36) vs. expectant management (n=45). Labor was induced using oxytocin (n=18), vaginal prostaglandins (n=6) or intrauterine balloon catheter (n=12) according to the Bishop score. Maternal and perinatal outcome variables were compared among both groups.
  
  
  RESULTS
  The characteristics of the labor induction group and the expectant management group were not statistically different, except for the rate of nulliparae (55.6% vs. 33.3%) and the rate of epidural analgesia (100% vs. 80%). There was no significant difference in labor time (6.5+/-2.8 h vs. 6.0+/-3.6 h), cesarean section rate (8.3% vs. 13.3%) or duration of maternal hospitalization (7.3+/-2.0 days vs. 7.5+/-2.3 days) in the labor induction group and in the expectant management group, respectively. The birth weight was higher in the labor induction group than in the expectant management group (2639+/-352 g vs. 2463+/-298 g, P<0.001). The rate of Apgar score <7 at 5 min was 0% and 3.3%, respectively. Neonatal intensive care unit admission occurred in 30.5% and 26.6% of the groups, respectively. No perinatal death was reported.
  
  
  CONCLUSIONS
  Induction of labor may be proposed to patients with uneventful twin pregnancy after 36 weeks gestation without increasing maternal-fetal morbidity.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital, 33076, Bordeaux, France.
authors.forename: T
authors.initials: T
authors.lastname: Harle
authors.forename: J L
authors.initials: JL
authors.lastname: Brun
authors.forename: J J
authors.initials: JJ
authors.lastname: Leng
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007751:Labor, Induced; D009017:Morbidity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011272:Pregnancy, Multiple