Randomized management of the second nonvertex twin: Vaginal delivery or cesarean section

Jaron Rabinovici, Gad Barkai, Brian Reichman, David M. Serr, Shlomo Mashiach

Research output: Contribution to journalArticlepeer-review

Abstract

Sixty twin deliveries after the thirty-fifth gestational week with vertex-breech and vertex-transverse presentations were managed according to a randomization protocol. Thirty-three parturient women (21 vertex-breech and 12 vertex-transverse presentations) were allocated for vaginal delivery and 27 for cesarean section (18 vertex-breech and nine vertex-transverse). Six pairs of twins in the vaginal delivery group were delivered in a different mode than requested by the protocol (two women underwent cesarean section; in four cases the second twin spontaneously changed to vertex presentation). There were no significant differences between 1- and 5-minute Apgar scores and incidence of neonatal morbidity between the second-born twins in both study groups. Firstborn twins had higher 1-minute Apgar scores than the second-born infants irrespective of route of delivery (p < 0.05). No case of birth trauma or neonatal death was recorded. Maternal febrile morbidity was significantly higher in the cesarean section group than in the vaginal delivery group (40.7% versus 11.1%, p < 0.05). These results suggest that in twins with vertex-breech or vertex-transverse presentations after the thirty-fifth week of gestational age the neonatal outcome of the second twin was not significantly influenced by the route of delivery.

Original languageEnglish
Pages (from-to)52-56
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume156
Issue number1
DOIs
StatePublished - Jan 1987

Keywords

  • Twin gestation
  • cesarean section
  • delivery

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