title: Prediction of safe and successful vaginal twin birth.
abstract: OBJECTIVE
  The objective of the study was to establish predictors of vaginal twin birth and evaluate perinatal morbidity according to mode of delivery.
  
  
  METHODS
  One thousand twenty-eight twin pregnancies were prospectively recruited. For this prespecified secondary analysis, obstetric characteristics and a composite of adverse perinatal outcome were compared according to the success or failure of a trial of labor and further compared with those undergoing elective cesarean delivery. Perinatal outcomes were adjusted for chorionicity and gestational age using a linear model for continuous data and logistic regression for binary data.
  
  
  RESULTS
  Nine hundred seventy-one twin pregnancies met the criteria for inclusion. A trial of labor was considered for 441 (45%) and was successful in 338 of 441 (77%). The cesarean delivery rate for the second twin was 4% (14 of 351). Multiparity and spontaneous conception predicted vaginal birth. No statistically significant differences in perinatal morbidity were observed.
  
  
  CONCLUSIONS
  A high prospect of successful and safe vaginal delivery can be achieved with trial of twin labor.
authors.affiliation: Royal College of Surgeons in Ireland, Dublin, Ireland. fbreathnach@rcsi.ie
authors.forename: Fionnuala M
authors.initials: FM
authors.lastname: Breathnach
authors.forename: Fionnuala M
authors.initials: FM
authors.lastname: McAuliffe
authors.forename: Michael
authors.initials: M
authors.lastname: Geary
authors.forename: Sean
authors.initials: S
authors.lastname: Daly
authors.forename: John R
authors.initials: JR
authors.lastname: Higgins
authors.forename: James
authors.initials: J
authors.lastname: Dornan
authors.forename: John J
authors.initials: JJ
authors.lastname: Morrison
authors.forename: Gerard
authors.initials: G
authors.lastname: Burke
authors.forename: Shane
authors.initials: S
authors.lastname: Higgins
authors.forename: Patrick
authors.initials: P
authors.lastname: Dicker
authors.forename: Fiona
authors.initials: F
authors.lastname: Manning
authors.forename: Stephen
authors.initials: S
authors.lastname: Carroll
authors.forename: Fergal D
authors.initials: FD
authors.lastname: Malone
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007746:Labor Presentation; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D014219:Trial of Labor; D014427:Twins