Occurrence and Clinical Predictors of Operative Delivery for the Vertex Second Twin After Normal Vaginal Delivery of the First Twin

Am J Obstet Gynecol. 2005 Jan;192(1):178-84. doi: 10.1016/j.ajog.2004.06.084.

Abstract

Objective: This study was undertaken to estimate occurrence and explore clinical predictors of abdominal and vaginal operative delivery in vertex second twin after normal vaginal delivery of the first twin.

Methods: Data from a historical cohort study that was based on a twin registry in the United States (1995-1997) were used.

Results: Among 42,417 vertex second twins following normal vaginal delivery of the first twins, rates of abdominal and vaginal operative delivery were 6.3% and 8.3%, respectively. Cord prolapse, fetal distress, maternal complications, abnormal labor, and birth weight 25% larger than first twin were the most important predicators for operative deliveries. Fetal distress and cord prolapse had a stronger effect on abdominal than vaginal operative delivery.

Conclusion: In general population, abdominal and vaginal operative delivery rates were 6.3% and 8.3%, respectively, in vertex second twin after normal vaginal delivery of the first twin. The most important predictors for operative delivery are cord prolapse and fetal distress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Birth Order*
  • Cesarean Section / statistics & numerical data*
  • Cohort Studies
  • Delivery, Obstetric / methods
  • Delivery, Obstetric / statistics & numerical data
  • Female
  • Fetal Distress / epidemiology*
  • Fetal Distress / etiology
  • Fetal Distress / surgery*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Labor Presentation*
  • Male
  • Obstetric Labor Complications / epidemiology
  • Obstetric Labor Complications / etiology
  • Obstetric Labor Complications / surgery
  • Parity
  • Pregnancy
  • Pregnancy Outcome
  • Twins*
  • United States / epidemiology