Twin Birth: Research Article

Felis

doi:10.58372/2835-6276.1037

Authors

Felis

DOI:

https://doi.org/10.58372/2835-6276.1037

Abstract

Observational epidemiological analyses have shown that there is a decreased risk of death and severe morbidity associated with cesarean delivery at term, but an increased risk at preterm gestational age. A multicenter international randomized controlled study compared planned cesarean delivery with vaginal birth and found no difference in the outcome. However, the trial included preterm and term births in approximately similar proportions. A subsequent reanalysis of the trial demonstrated that planned cesarean delivery was associated with an increased risk of adverse neonatal outcomes at preterm gestational ages but a reduced risk of perinatal complications at term, which is consistent with the epidemiological studies.

Therefore, when deciding on the type of delivery for twins, routine cesarean delivery should be discouraged for preterm deliveries. At term, the balance of risks and benefits will depend on the mother's priorities, her attitude towards managing the risks of unusual but potentially severe adverse events, and her plans for future pregnancies.

Obstetricians who care for twin pregnancies should be aware of the challenges that may arise during labor and delivery. With the recognition of these issues and proper training, obstetricians should be able to help women with twin pregnancies achieve a safe delivery for both mothers and their babies. With the use of breech extraction of the second twin and active management of the second stage of labor, women with twin pregnancies can achieve a high vaginal delivery rate for both twins.

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