Twin Deliveries – Where Are We Now?

The mode of delivery in twin gestation has been a matter of debate for decades. In 2013, the only randomized controlled trial concerning mode of delivery in twin gestations was published, answering some of the most pressing questions in this matter. The Twin Birth Study (TBS) randomized patients carrying dichorionic-diamniotic or monochorionic-diamniotic twins, with the first twin in cephalic presentation, between 32 and 39 weeks of gestation, to planned vaginal versus planned cesarean delivery, and found no significant differences in perinatal or maternal outcomes. In this chapter, we try to address the known literature before and after the publication of the TBS. We also review the literature with regard to scenarios beyond the scope of the TBS, such as delivery of preterm twins, the impact of chorionicity, combined delivery, and more.