[Vaginal birth after caesarean delivery in twin gestation: is trial of labor allowed?].
OBJECTIVE
To determine if a trial of labor in twin pregnancy with previous cesarean section is an acceptable alternative to systematic cesarean section.


METHODS
Based on a retrospective and comparative study from 1st January 1996 to 30th June 2003 in Maternite Jeanne-de-Flandre (Lille) and Pavillon Paul-Gelle (Roubaix), 35 trials of labor in twin pregnancies with previous cesarean section have been compared with 35 twin gestations attempting vaginal delivery without a prior cesarean. This comparative study has been led by sorting out the patients according to their gestational age, parity and maternity.


RESULTS
Twenty-seven women (77%) delivered vaginally and eight (23%) by elective caesarean section. Postpartum hemorrhage was more frequent for caesarean section (75%). No scare dehiscence or rupture occurred. There was not any haemostasis hysterectomy or embolisation related to postpartum haemorrhage. Neonatal outcome was similar in both groups.


CONCLUSIONS
Twin trial of labor after a previous cesarean section seems to be a safe alternative to routine repeat cesarean delivery as maternal and fetal morbidity and mortality are safe.
Coutty
N
N
Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille, France.
Deruelle
P
P
Delahousse
G
G
Le Goueff
F
F
Subtil
D
D
D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007746:Labor Presentation; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012449:Safety; D014219:Trial of Labor; D014427:Twins; D014597:Uterine Rupture / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean