[Breech extraction of the second twin with or without version by internal maneuvers].

A retrospective study was done to appraise the recent practice of breech extraction of the second twin (with or without internal version) in our unity. From January 1st, 1988 to April 30, 1991 23 patients with a twin gestation were delivered in our unity (0.5% of all deliveries). Nineteen patients (83%) were delivered vaginally. Each procedure was done by a resident under control of a senior obstetrician and in the presence of two midwives, a pediatrician, and an anesthesiologist. Ten patients having had a breech extraction (GE group) were studied, 13 patients were excluded for not having had a breech extraction. In the GE group the presentations were: 7 vertex/breech and 3 breech/breech. Mean Apgar scores of the second twin at 3 minutes were 8 in the GE group. These results suggest that breech extraction of the second twin is not a pernicious technique if done by trained operators with precise limits. These results need to be confirmed through a prospective randomized and comparative study.