title: Induction of labor in twin gestation: lessons from a population based study.
abstract: BACKGROUND
  The route of delivery and the role of induction of labor in twin gestations are controversial. The aim of this study was to determine the efficacy of induction of labor in twin gestations.
  
  
  METHODS
  This retrospective population based cohort study included 4605 twin gestations divided into following groups: 1) spontaneous parturition (n = 2937, 63.78%); 2) induction of labor (n = 653, 14.2%) and 3) elective cesarean delivery (n = 1015, 22.04%).
  
  
  RESULTS
  The rate of vaginal delivery in the labor induction group was 81% (529/653). In comparison to the other study groups, induction of labor in twins was independently associated with a 77% reduction in the risk of cesarean delivery (OR 0.23; 95% CI 0.18-0.31) and a 78% reduction in the risk of postpartum death for the second twin (OR 0.22; 95% CI 0.05-0.94). The rate of nulliparity, term delivery and labor dystocia was higher in the induction of labor group (p < 0.001 in all comparisons).
  
  
  CONCLUSIONS
  Our results suggest that induction of labor in twin gestation is successful and is independently associated with substantial reduction in the risk of cesarean delivery and postpartum death of the second twin.
authors: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel .
authors: Batel
authors: B
authors: Hamou
authors: b Department of Epidemiology , Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel .
authors: Tamar
authors: T
authors: Wainstock
authors: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel .|c Department of Obstetrics and Gynecology , Azienda Ospedaliera Universitaria Policlinico Di Bari, School of Medicine, University of Bari "Aldo Moro" , Bari , Italy .
authors: Salvatore Andrea
authors: SA
authors: Mastrolia
authors: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel .
authors: Ruthy
authors: R
authors: Beer-Weisel
authors: d Department of Neonatology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel , and.
authors: Orna
authors: O
authors: Staretz-Chacham
authors: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel .
authors: Doron
authors: D
authors: Dukler
authors: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel .
authors: Tal
authors: T
authors: Rafaeli-Yehudai
authors: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel .
authors: Moshe
authors: M
authors: Mazor
authors: e Maternity Department D, Obstetrical Day Care Unit, Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors: Offer
authors: O
authors: Erez
mesh_terms: D000328:Adult; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods*; D004420:Dystocia / Q000517:prevention & control; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods*; D008297:Male; D054238:Perinatal Mortality; D011247:Pregnancy; D059285:Pregnancy, Twin; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cesarean delivery; Foley catheter; oxytocin; prostaglandins; term pregnancy