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PL.68 When Should Twin Induction of Labour Start to Increase the Chances of Daytime Delivery?
  1. M Tattersall1,
  2. L Bricker2
  1. 1University of Liverpool, Liverpool, UK
  2. 2Liverpool Women’s Hospital, Liverpool, UK


Background Vaginal twin deliveries can be complicated and senior obstetrician presence may be advisable. Our unit has consultant on-site presence between 08:30 and 20:30, so we sought to determine when inductions should be commenced to maximise deliveries during these “daytime” hours.

Methods Women having prostaglandin induction after 36 weeks, resulting in at least one vaginal delivery and where no delays to normal care occurred were selected. Nulliparous and parous women were considered separately and the percentage of “daytime” deliveries calculated for inductions commenced in the morning (06:00 – 11:59), afternoon (12:00 – 17:59) and evening (18:00 – 23:59). (Inductions commenced 00:00 – 05:59 were excluded due to infrequency.) Analysis of length of labour (defined from start time to delivery of first twin) was performed.

Results The majority of inductions were commenced in the morning. For nulliparous women, 71% of morning-commenced inductions resulted in “daytime” deliveries, compared with 50% and 67% of afternoon-commenced and evening-commenced procedures. Labour length was normally distributed with mean of 21.8 hours (SD 7.9 hours). For parous women, afternoon-commenced induction produced a higher percentage of “daytime” deliveries; 85% compared with 50% and 67% for morning-commenced and evening-commenced inductions. Labour length was normally distributed with mean of 15.0 hours (SD 7.0 hours).

Conclusions For nulliparous women, commencing induction in the morning provides a high likelihood of “daytime” delivery. For parous women, analysis of inductions by start time and mean length of labour suggests a trial of commencing induction later in the day might increase the proportion of “daytime” deliveries.

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