Evidence map›Paper›PMID 28061767›Full record

Trial reportBMC pregnancy and childbirth2017

The effect of induction method in twin pregnancies: a secondary analysis for the twin birth study.

Elad Mei-Dan, Elizabeth V Asztalos, Andrew R Willan, Jon F R Barrett

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
4.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 31 citations in OpenAlex.

  1. Trial
  2. Early versus late amniotomy during twin labor.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Article
  3. Induction of Labor in Twins-Double Trouble?Journal of clinical medicine · 2023
    Article
  4. Twin Deliveries - East Meets West.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2022
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Elad Mei-DanWomen and Babies Program, Sunnybrook Health Sciences Center, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada. elad.mei-dan@sunnybrook.ca.
Elizabeth V AsztalosWomen and Babies Program, Sunnybrook Health Sciences Center, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.
Andrew R WillanChild Health Evaluative Sciences, SickKids Research Institute, University of Toronto, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, ON, Canada.
Jon F R BarrettWomen and Babies Program, Sunnybrook Health Sciences Center, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.
Sunnybrook Health Science Centre · CASunnybrook Research InstituteUniversity of Toronto · CA

Funding

CIHR 63164
6 · The paper itself

Abstract

backgroundThis secondary analysis for the Twin Birth Study, an international, multicenter trial, aimed to compare the cesarean section rates and safety between methods of induction of labor in twin pregnancies.

methodsWomen with twin pregnancies where the first twin was in a cephalic presentation and who presented for labor induction, were non-randomly assigned to receive prostaglandin or amniotomy and/or oxytocin. Main outcome measures were the rates of unplanned cesarean section and neonatal and maternal mortality or serious morbidity.

results153 (41.5%) were induced by prostaglandin (prostaglandin group) and 215 (58.5%) were induced by amniotomy and/or oxytocin alone (no prostaglandin group). Induction using prostaglandin was more common in countries with a low perinatal mortality rate <10/1000 (45.7 versus 32.5%, p = 0.02). Cesarean section rates were similar in the two groups: 62/153 (40.5%) in the prostaglandin group and 87/215 (40.5%) in the no prostaglandin group (odds ratio 1, 95% CI 0.65-1.5). Nulliparity, late maternal age, non-cephalic presentation of twin B and high country's perinatal mortality rate were found to be independently associated with the induction to end with an unplanned cesarean section. There were no significant differences between groups with respect to maternal or neonatal adverse outcomes.

conclusionsThe need for cervical ripening by prostaglandin had no effect on the incidence of cesarean delivery or an abnormal outcome. There is a significant risk of unplanned cesarean section independent of chosen induction method.

trial registrationThis trial was registered at the International Standard Randomized Controlled Trial Register (identifier ISRCTN74420086 ; December 9, 2003) and retrospectively registered at the www.clinicaltrials.gov (identifier NCT 00187369 ; September 12, 2005).

Indexed as

AdultAmniotomyCervical RipeningCesarean SectionFemaleHumansInfant, NewbornLabor, InducedLabor PresentationMaternal AgeMaternal MortalityOxytocicsOxytocinPerinatal MortalityPregnancyPregnancy, TwinOxytocicsOxytocinProstaglandinsCesarean sectionInduction of laborProstaglandinsTwins

Identifiers

PMID28061767
PMCPMC5217445
OpenAlexW2568512245

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.