Early versus late amniotomy during twin labor

OBJECTIVE: This study evaluates whether timing of amniotomy affects labor characteristics and maternal and neonatal outcomes in twin deliveries. METHODS: This retrospective study was conducted at a single academic medical center and included dichorionic diamniotic (DCDA) twin pregnancies with a normal anomaly scan and a vertex-presenting leading twin, delivered over a 7-year period. The cohort was divided into two groups: early amniotomy (performed at cervical dilation ≤3 cm) and late amniotomy (performed at >3 cm cervical dilation). Exclusion criteria included monochorionic twin pregnancies and planned elective cesarean deliveries. Maternal demographics, delivery characteristics, and neonatal outcomes were compared between groups. RESULTS: ), comorbidities, and gestation. Nulliparity and intrapartum cesarean rates were more common in the early amniotomy group (56.6% vs. 29.4%; P < 0.001, 24.4% vs. 9.8%; P < 0.001, respectively). Induction and augmentation rates, rupture-to-delivery interval, second stage duration, intrapartum fever, and meconium were similar. Neonatal outcomes, including birthweight, 5-min Apgar