Abstract
The number of multiple pregnancy is increasing with assisted reproductive technology year after year. Official organisations recommended vaginal delivery in twin pregnancy without contraindication for vaginal delivery. To result in successful outcome, skilled obstetrician who are experienced with intrauterine fetal manipulation is essential. However, it is not well known that how many cases of vaginal delivery in twin pregnancy make obstetricians competent. So this study aims at characterising the learning curve of successful vaginal delivery in twin pregnancy. The study population consisted of twin pregnant women who delivered in Seoul National University Hospital (SNUH) from 2001 through 2018. Women with trial of labour at or after 28 weeks were included (N = 2079). We had 6 groups divided into every 3 years. We compared the rate of successful and failed vaginal delivery (Caesarean delivery or combined delivery) in each period. We performed statistical analysis using SPSS 23.0 with x2-test. During the study period, the number of twin delivery gradually increased from 5% to 20%. The rate of twin pregnancies with trial of labour was more than 60% after early period (2001-2006). As time goes by, the increased rate of vaginal delivery was found and the rate of combined delivery decreased (table 1). In an analysis of nulliparous women, successful vaginal delivery reached a plateau in 80% after 200 cases and combined delivery rate decreased to less than 1% after 600 cases. Too much experience is required for experts in twin vaginal delivery. We have to establish teaching program to reduce the cases we need to be an expert. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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