title: Maternal postpartum complications according to delivery mode in twin pregnancies.
abstract: OBJECTIVE
  We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors.
  
  
  METHODS
  This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008). The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated.
  
  
  RESULTS
  A total of 90 complications were observed in 56/817 (6.9%) deliveries: 7/131 (5.3%) vaginal, 10/251 (4.0%) elective cesarean and 39/435 (9.0%) emergency cesarean deliveries. Significant predictors included high-risk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR=2.34).
  
  
  CONCLUSIONS
  Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
authors.forename: Sonia Leme
authors.initials: SL
authors.lastname: Stach
authors.affiliation: Department of Obstetrics and Gynecology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
authors.forename: Adolfo Wenjaw
authors.initials: AW
authors.lastname: Liao
authors.affiliation: Department of Obstetrics and Gynecology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Brizot
authors.affiliation: Department of Obstetrics and Gynecology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
authors.forename: Rossana Pulcineli Vieira
authors.initials: RP
authors.lastname: Francisco
authors.affiliation: Department of Obstetrics and Gynecology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008423:Maternal Age; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult