Evidence map›Paper›PMID 41906080›Full record

ArticleBMC pregnancy and childbirth2026

Predicting cesarean delivery in twin pregnancies undergoing trial of labor: a multicenter cohort study.

Matan Papier, Tzuria Peled, Maayan Bas Lando, Sorina Grisaru-Granovsky, Hen Y Sela, Misgav Rottenstreich

Abstract readMulticenter Study
In one paragraph

Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Matan Papier *Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Tzuria Peled *Department of Obstetrics & Gynecology, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, 12 Bayit Street, Jerusalem, 91031, Israel.
Maayan Bas LandoDepartment of Obstetrics & Gynecology, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, 12 Bayit Street, Jerusalem, 91031, Israel.
Sorina Grisaru-GranovskyDepartment of Obstetrics & Gynecology, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, 12 Bayit Street, Jerusalem, 91031, Israel.
Hen Y SelaDepartment of Obstetrics & Gynecology, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, 12 Bayit Street, Jerusalem, 91031, Israel.
Misgav RottenstreichDepartment of Obstetrics & Gynecology, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, 12 Bayit Street, Jerusalem, 91031, Israel. misgavr@gmail.com.ORCID http://orcid.org/0000-0003-4875-1455

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify risk factors associated with intrapartum cesarean delivery (CD) among twin pregnancies undergoing a trial of labor (TOL). STUDY

designA retrospective, multicenter cohort study was conducted at two medical centers between 2005 and 2024. Inclusion criteria were diamniotic twin pregnancies who underwent TOL, first twin in cephalic presentation, gestational age between 32 0/7 and 40 6/7 weeks, and undergoing a TOL. Multivariate logistic regression was performed to identify independent risk factors for intrapartum CD.

resultsA total of 2,730 twin pregnancies who underwent TOL met criteria and were included. The intrapartum CD rate was 6.5% (n = 177); 15.3% for primiparous women and 4.1% for multiparous women. Suspected fetal distress and labor dystocia were the most frequent indications for CD, 45.2% and 35.0% respectively. Multivariate analysis revealed that primiparity was the strongest independent predictor of intrapartum CD (adjusted Odds Ratio [aOR] 5.81, 95% CI: 2.67–12.63). Additional significant risk factors included large for gestational age (LGA) presenting twin (aOR 4.27, 95% CI: 1.95–9.34), maternal obesity (BMI > 30 kg/m2) (aOR 3.29, 95% CI 1.72–6.30), and cervical dilation < 3 cm at admission (aOR 2.30, 95% CI: 1.18–4.50).

conclusionIn twin pregnancies undergoing TOL, primiparity, LGA presenting twin, maternal obesity, and limited cervical dilation upon admission are significant, independent risk factors for intrapartum CD. These findings can improve risk stratification and support evidence-based patient counseling.

Indexed as

Cesarean SectionPregnancy, TwinTrial of LaborAdultDystociaFemaleFetal DistressGestational AgeHumansInfant, Large for Gestational AgeLogistic ModelsParityPregnancyRetrospective StudiesRisk FactorsIntrapartum cesarean deliveryLarge for gestational ageMaternal obesityPrimiparityRisk factorsTrial of laborTwin pregnancy

Identifiers

PMID41906080
PMCPMC13154582

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.