[Indications for cesarean section in the delivery of the 2d twin after vaginal birth of the 1st twin].

Cesarean section for delivery of twin B after vaginal delivery of twin A is a rare and extraordinary event in obstetrics. From 1.1.82-31.12.86, from a total number of 9357 deliveries, 133 pairs of twins (1.4%) were born. In 3 cases (2.2%) twin B was delivered by cesarean section after vaginal delivery of twin A. Taking into account 51 published cases in the recent literature, the indications for cesarean delivery of the second twin were demonstrated and compared. In the main, emergency situations presenting more than one obstetrical complication were responsible for this uncommon practice. Regarding the results presented, cesarean section of the second twin after vaginal delivery of the first-born seems to be a proven procedure to deliver the second twin faster and more safely than by hazardous vaginal manipulations, especially in obstetrical emergency situations.