title: Twin pregnancy outcomes after increasing rate of vaginal twin delivery: retrospective cohort study in a Hong Kong regional obstetric unit.
abstract: OBJECTIVE
  To determine any change in adverse neonatal/maternal outcomes after increasing the rate of vaginal twin delivery by comparing vaginal twin delivery and caesarean delivery with our previous cohort study.
  
  
  METHODS
  In a retrospective cohort study, all twins booked at a Hong Kong regional obstetrics unit were evaluated during a 3-year period from 1 April 2009 to 31 March 2012.
  
  
  RESULTS
  Out of the 269 sets of twins who eventually delivered in our unit, 68 (25.3%) of them were delivered vaginally, compared to 15.8% in our previous cohort study (p = 0.02). For those who were suitable for vaginal delivery, significantly more women attempted vaginal delivery: 93/133 (69.9%) versus 47/100 (47%) (p = 0.0005). The success rate for vaginal delivery and rate of requiring caesarean delivery for the 2nd twin were similar between these two periods. There were significantly more 2nd twins with cord blood pH < 7.2 when both twins were delivered by vaginal delivery. Otherwise, there was no significant difference between other neonatal/maternal morbidities.
  
  
  CONCLUSIONS
  With proper counseling, significantly more women who were suitable for vaginal twin delivery would opt to do so. There was no significant increase in neonatal/maternal morbidities despite the increased rate of vaginal twin delivery.
authors.affiliation: a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
authors.forename: Hiu Tung
authors.initials: HT
authors.lastname: Tang
authors.affiliation: a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
authors.forename: Ah Lai
authors.initials: AL
authors.lastname: Liu
authors.affiliation: a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
authors.forename: Sum Yee
authors.initials: SY
authors.lastname: Chan
authors.affiliation: a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
authors.forename: Chin Ho
authors.initials: CH
authors.lastname: Lau
authors.affiliation: a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
authors.forename: Wai Kuen
authors.initials: WK
authors.lastname: Yung
authors.affiliation: a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
authors.forename: Wai Lam
authors.initials: WL
authors.lastname: Lau
authors.affiliation: a Department of Obstetrics and Gynaecology , Kwong Wah Hospital , Hong Kong.
authors.forename: Wing Cheong
authors.initials: WC
authors.lastname: Leung
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D009775:Obstetrics and Gynecology Department, Hospital; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D059285:Pregnancy, Twin / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014427:Twins; D014621:Vagina
keywords: Caesarean delivery; maternal outcome; neonatal outcome; twins; vaginal delivery