Can planned caesarean section prevent long-term urinary stress incontinence in twin pregnancy?

Abstract

Urinary stress incontinence and other maternal outcomes 2 years after caesarean or vaginal birth for twin pregnancy: a multicenter randomised trial. Hutton at al., for the Twin Birth Study Collaborative Group, BJOG 2018;125:1682–90. To view this article visit https://doi.org/10.1111/1471-0528.15407 You are caring for a woman who is 32 weeks into her first pregnancy with dichorionic diamniotic (DCDA) twins. The pregnancy is uncomplicated and the first twin is cephalic. How do you plan her delivery? Women between 320/7 and 386/7 weeks of gestation with diamniotic twin pregnancy, where the first twin was in the cephalic position. Planned caesarean section. Planned vaginal delivery. Urinary stress incontinence, or fecal or flatal incontinence at 2 years. Perspective longitudinal study. For women with twins, compared with planned vaginal birth, planned caesarean is associated with a decreased prevalence (odds ratio, OR 0.63; 95% confidence interval, 95% CI 0.47–0.83) but not severity of urinary stress incontinence at 2 years. Hill KG, Woodward D, Woelfel T et al. Planning for long-term follow-up: strategies learned from longitudinal studies. Prev Sci 2016;17:806. Barret et al. A randomized trial of planned cesarean or vaginal delivery for twin pregnancy. N Engl J Med 2013;369:1295–1305.