Delivery of the second twin.

OBJECTIVE

To determine the likelihood of cesarean for the second twin after vaginal delivery of the first and the risk of vaginal delivery.

METHOD: A retrospective analysis of twin deliveries was performed on 10,365 live born twin pairs (20,730 births), using birth certificate data from the State of Illinois from 1997 through 2000.

RESULT: The incidence of cesarean for the second twin after vaginal delivery of the first was 10.1%. The greatest incidence of failed vaginal delivery of the second twin was in the vertex/non-vertex group. Five-minute Apgar scores <4 were significantly more frequent in vaginally delivered twins <2000 g compared to those delivered via cesarean (p<0.001).

CONCLUSION

Twin presentation type is predictive of the likelihood of a failed vaginal delivery of the second twin. Cesarean appears to significantly reduce the incidence of Apgars <4 for neonates <2000 g.