The aim of this study was to identify the rate of vaginal birth after cesarean (VBAC) attempt, VBAC failure, and maternal morbidities in patients with twin gestations after a previous cesarean delivery.
A retrospective cohort study including all parturient with twin gestation and a history of previous cesarean delivery between 2005 and 2015 was performed. We compared the incidence of adverse maternal outcomes between women with planned vaginal birth and women with planned repeat caesarean section.
During the study period, 368 women with twin gestation and a previous cesarean delivery met the inclusion criteria. Of those, 317 (86.1%) had planned repeat cesarean delivery and 51 (13.9%) attempted vaginal birth. Of the 51 women who attempted a trial of labor, 47 women had successful VBAC (success rate, 92.2%), and only 4 women (7.8%) had a failed trial of labor. One of the failed trials of labor involved a vaginal delivery for twin A and cesarean delivery for twin B. Women who attempted a trial of labor with twins had no increased risk of maternal morbidity, including uterine rupture and post-partum hemorrhage, when compared with planned repeat cesarean delivery.
In this retrospective study, trial of labor with twins after previous cesarean delivery was not found to be associated with an increased risk for maternal morbidity, including uterine rupture, and appear to have similar risk to those of planned repeat cesarean delivery.
© 2017 Published by Elsevier Inc.