title: Is induction of labor risky for twins compare to singleton pregnancies?
abstract: OBJECTIVE
  The aim of this study was to investigate whether induction of labor in twin pregnancies is associated with higher rates of maternal complications as compared to singletons.
  
  
  METHODS
  A retrospective population-based study was conducted to compare maternal complications following induction of labor in twin pregnancies and singletons at Soroka University Medical Center, Be'er-Sheva, Israel, between 1988 and 2010. Stratified analysis using a multiple logistic regression model was performed to control for confounders.
  
  
  RESULTS
  The study population included 25 913 patients following induction of labor, of these 191 (0.73%) were in twin pregnancies. Induction of labor in twin pregnancies was not associated with adverse maternal outcomes such as cervical tears, third degree perineal tears, uterine rupture, peripartum hysterectomy, post-partum hemorrhage or retained placenta. However, labor induction in twins was significantly associated with cesarean deliveries (31.2% versus 17.1%; p < 0.001). Using a multivariable analysis controlling for confounders, induction at twins was an independent risk factor for cesarean delivery (CD; adjusted OR = 2.2, 95% CI 1.7-2.7, p < 0.001).
  
  
  CONCLUSIONS
  Induction of labor in twin pregnancies does not increase the risk for maternal complications. However, it is an independent risk factor for CD.
authors.affiliation: Soroka University Medical Center , Beer Sheva , Israel and.
authors.forename: Rania
authors.initials: R
authors.lastname: Okby
authors.forename: Ilana
authors.initials: I
authors.lastname: Shoham-Vardi
authors.forename: Sergienko
authors.initials: S
authors.lastname: Ruslan
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects* / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology*; D018457:Placenta, Retained / Q000453:epidemiology / Q000209:etiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D059285:Pregnancy, Twin / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014427:Twins