Twin delivery: Method, timing and conduct

The incidence of twin pregnancy has increased worldwide over the past 10 years, largely as a consequence of the assisted reproductive technologies. Issues such as intrapartum monitoring and operative interventions, especially relating to the second twin, provide a unique challenge in labour and deli...

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Bibliographic Details
Published in:Best practice & research. Clinical obstetrics & gynaecology 2014-02, Vol.28 (2), p.327-338
Main Author: Barrett, Jon F.R., MBBcH, MD, FRCOG, FRCSC
Format: Article
Language:English
Subjects:
Breech Presentation
Canada - epidemiology
Cesarean Section
Delivery, Obstetric - adverse effects
Delivery, Obstetric - methods
epidural in twin delivery
Female
Humans
Incidence
Infant, Newborn
Obstetrics and Gynecology
Pregnancy
Pregnancy Outcome
Pregnancy, Twin
Risk Assessment
Risk Factors
the non-vertex second twin
Time Factors
time interval in twin delivery
Twin Birth Study
twin caesarean section
twin gestation
twin pregnancy
Twins - statistics & numerical data
vaginal delivery in twins
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Summary:The incidence of twin pregnancy has increased worldwide over the past 10 years, largely as a consequence of the assisted reproductive technologies. Issues such as intrapartum monitoring and operative interventions, especially relating to the second twin, provide a unique challenge in labour and delivery. Epidemiological and cohort data suggest that twins have a three-fold higher mortality rate than singletons, and that the second twin might have a better outcome if delivered by lower segment caesarean section. The recently completed Twin Birth Study has found that planned vaginal lower segment caesarean section is not advantageous to the fetus. In the light of this large randomised-controlled trial, vaginal delivery if twin A presents by the vertex is recommended as long as guidelines for the conduct of such delivery are followed.
ISSN:1521-6934
1532-1932
DOI:10.1016/j.bpobgyn.2013.12.008