{'fraction_non_alphanumeric': 0.06367292225201072, 'fraction_numerical': 0.04289544235924933, 'mean_word_length': 4.809338521400778, 'pattern_counts': {'":': 0, '<': 5, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Vaginal birth as compared to Cesarean section in Preterm Twins - Experience from a tertiary center of a middle-income country.

OBJECTIVES
To evaluate the mode of birth in early-preterm, late-preterm, and near-term twins as well as to compare the maternal and neonatal outcomes of each group following vaginal birth (VB) and cesarean section (LSCS).


METHODS
A prospective cohort study of 100 twin pregnancies in a tertiary center between 2018 and 2019. Deliveries were allocated into three gestational age (weeks+days) groups and compared: (1) early-preterm (28-31+6), (2) late-preterm (32-35+6) and (3) near-term (≥36).


RESULTS
The proportion of VB and LSCS were similar when early (P=0.766; RR-1.08) and late-preterm twins (P=0.071; RR-1.21) were compared separately with near-term twins. Perinatal outcomes did not differ between VB and LSCS within each gestational age group. When compared with near-term born, the early-preterms had more hypoglycemia (P<0.001), hyperbilirubinemia (P<0.001), respiratory distress (P<0.001), low Apgar scores (P<0.001), and death (P<0.001) irrespective of the mode of birth. The late-preterms had lower morbidity and mortality (P=0.227). Postpartum hemorrhage and blood transfusion were similar between the groups.


CONCLUSION
The proportion of VB and LSCS and associated maternal and neonatal outcomes did not differ in twins of different gestational ages. The data provides reassurance to practitioners to perform vaginal delivery in preterm twins.