[Effect of birth interval on the rate of cesarean section for the second twin after vaginal delivery of the first twin].

Cesarean section for delivery of the second twin after successful vaginal delivery of the first twin is an infrequent and unusual occurrence. But this management of twin delivery has increased during the last years. A series of 371 pairs of twins born between 1978 and 1991 were reviewed. 12 second twins (3.2%) were delivered by cesarean section after vaginal delivery of the first twin. The initial 20 minutes the main indications were fetal distress and prolapsed umbilical cord. Beyond the first 20 minutes malpresentations were more frequent. In this group we have seen a better fetal outcome. An influence of the interdelivery time on the cesarean section rate of the second twin was not noted. No significant differences were seen for neonatal morbidity for all 197 vaginal delivered second twins with increasing interval.