Abstract
To compare the length of labor in twin gestations compared with singletons. This is a retrospective analysis of all twin and singleton labors at a single institution from 1990-2008. All spontaneous laboring women who achieved a vaginal delivery at 34-42 weeks gestational age were included. Length of first stage was calculated from the onset of painful contractions with cervical change until complete cervical dilation. Second stage was calculated from time of complete dilation until delivery of the singleton or the first twin. Mean labor length was compared using t-tests, and Kaplan-Meyer survival curves were tested with log-rank statistics. There were 19,853 singletons and 404 twins included in the analysis. The mean length of the first stage of labor was 615 min for singletons and 557 min for twins (p=0.03). The mean length of the second stage of labor was 97 min for singletons and 94 min for twins (p=0.27). For nulliparous women alone, the mean first stage of labor for singletons was 727 min and 599 min for twins (p=0.001), while the mean length of the second stage was 132 min for singletons and 137 for twins (p=0.35). When survival analysis of labor length was performed for these nullipararas, the first stage of labor is significantly shorter for women with twin gestations. There is no difference in the length of the second stage. Women with twin gestations presenting in spontaneous labor at 34-42 weeks have a shorter mean and median of the first stage of labor by approximately 2 hours, and are likely to reach complete dilation sooner than women with singletons. There is no difference in the second stage of labor. Tabled 1 View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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