OXYTOCIN LABOR STIMULATION OF TWIN GESTATIONS - EFFECTIVE AND EFFICIENT

Objective: To test the hypothesis that oxytocin labor stimulation of t win gestations is similar to that of singletons regarding dosage, time , complications, and ability to achieve vaginal delivery. Methods: Thi s retrospective investigation included 124 gravidas receiving oxytocin for augmentation or induction of labor. Sixty-two women with twin ges tations were matched by parity, cervical dilation at initiation of oxy tocin, gestational age, oxytocin dosage regimen, and indications for o xytocin to controls with singleton pregnancies. Outcome variables incl uded maximum dosage of oxytocin, incidence of hyperstimulation and fet al heart rate (FHR) abnormalities, time from oxytocin to delivery, ces arean deliveries, and maternal and neonatal outcomes. Statistical anal ysis was done using McNemar test paired t test, and Wilcoxon signed-ra nk test for paired samples. Results: Women with twin pregnancies and t hose with singletons responded similarly regarding maximum oxytocin do sage (21 +/- 1.5 and 18 +/- 2.4 mU/minute, respectively, P = .1), time from oxytocin to delivery (7.0 +/- 0.8 and 6.7 +/- 0.6 hours, respect ively, P = .88), and successful vaginal delivery (90% and 90%, respect ively). Oxytocin stimulation of twins resulted in fewer interruptions of the infusion for FHR abnormalities (5% compared with 26%, odds rati o [OR] 0.27, 95% confidence interval [IC] 0.16, 0.47) and hyperstimula tion (6% compared with 18%, OR 0.19, 95% CI 0.36, 0.99). Conclusion: T win gestation has no adverse impact on the effectiveness or efficiency of oxytocin labor stimulation. Twin pregnancy seems to be associated with fewer side effects.