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Case 76 - A 20-Year-Old at 37 Weeks with a Twin Gestation Presents for Delivery Planning

from Section 8 - Fetal Complications

Published online by Cambridge University Press:  08 April 2025

By
Eric Strand
Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

Twin pregnancies are associated with higher risks for both maternal and fetal/neonatal complications. Planning delivery of a twin pregnancy requires knowledge of both placentation (chorionicity/amnionicity) and fetal presentations. For diamniotic twins with a cephalic presenting twin, attempted vaginal delivery provides comparable neonatal outcomes with lower maternal morbidity – vaginal delivery should be offered to these patients. Providers offering vaginal twin delivery should be skilled in both external cephalic version and breech extraction.

Keywords

twin pregnancytwin deliverybreech extraction
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 235 - 237
Publisher: Cambridge University Press
Print publication year: 2025

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References

American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice; Society for Maternal-Fetal Medicine. Medically Indicated Late-Preterm and Early-Term Deliveries: ACOG Committee Opinion, Number 831. Obstet Gynecol. 2021;138(1):e35–e39.Google Scholar
Multifetal Gestations: Twin, Triplet, and Higher Order Multifetal Pregnancies: ACOG Practice Bulletin, Number 231. Obstet Gynecol. 2021;137(6):e145–e162.CrossRefGoogle Scholar
American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine; Caughey, AB, Cahill, AG, Guise, JM, Rouse, DJ. Safe Prevention of the Primary Cesarean Delivery. Am J Obstet Gynecol. 2014;210(3):179–193.CrossRefGoogle ScholarPubMed
Barrett, JF, Hannah, ME, Hutton, EK, et al. A Randomized Trial of Planned Cesarean or Vaginal Delivery for Twin Pregnancy. N Engl J Med. 2013;369(14):1295–1305.CrossRefGoogle ScholarPubMed
Hofmeyr, GJ, Barrett, JF, Crowther, CA. Planned Caesarean Section for Women with a Twin Pregnancy. Cochrane Database Syst Rev. 2015;(12):CD006553.CrossRefGoogle Scholar
Easter, SR, Lieberman, E, Carusi, D. Fetal Presentation and Successful Twin Vaginal Delivery. Am J Obstet Gynecol. 2016;214(1):116.e1–116.e10.Google ScholarPubMed
Fox, NS, Silverstein, M, Bender, S, et al. Active Second-Stage Management in Twin Pregnancies Undergoing Planned Vaginal Delivery in a U.S. Population. Obstet Gynecol. 2010;115(2 Pt. 1):229–233.Google Scholar
Aviram, A, Lipworth, H, Asztalos, EV, et al. The Worst of Both Worlds-Combined Deliveries in Twin Gestations: A Subanalysis of the Twin Birth Study, a Randomized, Controlled, Prospective Study. Am J Obstet Gynecol. 2019;221(4):353.e1–353.e7.CrossRefGoogle ScholarPubMed
Rydhström, H, Ingemarsson, I. Interval between Birth of the First and the Second Twin and Its Impact on Second Twin Perinatal Mortality. J Perinat Med. 1990;18(6):449–453.Google ScholarPubMed

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