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Chapter 24 - Mode of Delivery in Multiple Pregnancy

Published online by Cambridge University Press:  11 October 2022

By
Amir Aviram ,
Jon F. R. Barret ,
Elad Mei-Dan  and
Nir Melamed
Edited by
Leanne Bricker ,
Julian N. Robinson  and
Baskaran Thilaganathan
Leanne Bricker
Affiliation:
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Affiliation:
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
Affiliation:
St George's Hospital Medical School, University of London
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Summary

The Mode of delivery in twin gestation has long been a matter of debate. The Twin Birth Study (TBS) supplied care givers with an answer to some of the questions. In patients with twin gestation between 32 and 38 weeks of gestation, with the first twin in cephalic presentation, that match the inclusion criteria of the TBS, the neonatal and maternal outcomes of a planned trial of a vaginal delivery are not different than those associated with a planned cesarean section. Yet, gestational age at birth, estimated fetal weight and weight difference between the twins, presentations, chorionicity, care giver’s experience – are some of the many factors that influence the decision regarding mode of delivery, and the outcome of birth in multiple pregnancy. This chapter will describe the evidence or in its absence expert view with regard to mode of delivery in uncomplicated twin pregnancy but also special circumstances such as delivery of the non-vertex second twin, combined delivery, time interval between delivery of twins, breech presenting twin, monoamniotic twins, monochorionic diamniotic twins, vaginal birth after caesarean in twins, preterm and low birthweight twins and higher order multiples.

Keywords

twinsmode of deliverytiming of deliverymanagementneonatal outcomes
Type
Chapter
Information
Management of Multiple Pregnancies
A Practical Guide
 , pp. 249 - 258
Publisher: Cambridge University Press
Print publication year: 2022

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References

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