TY - CHAP M1 - Book, Section TI - Delivery of Twin Gestations A1 - Yeomans, Edward R. A1 - Hoffman, Barbara L. A1 - Gilstrap III, Larry C. A1 - Cunningham, F. Gary Y1 - 2017 N1 - T2 - Cunningham and Gilstrap's Operative Obstetrics, 3e AB - Twins account for 3.3 percent of all births in the United States. This near doubling of the incidence since 1980 is attributable to advancing maternal age at conception and increasing use of assisted reproductive technology (American College of Obstetricians and Gynecologists, 2014a). During roughly the same period, the cesarean delivery rate for twins has increased to 75 percent, thereby reducing the overall experience with vaginal delivery of twins (Lee, 2011). Germane to this, an obstetric care consensus developed jointly by the American College of Obstetricians and Gynecologists (2014b) and the Society for Maternal-Fetal Medicine concluded that perinatal outcomes when the first twin presents cephalic are not improved by cesarean delivery. This document states that for twins with cephalic/cephalic or cephalic/noncephalic presentations, obstetric care providers should counsel women to attempt vaginal delivery. Such a strong recommendation assumes that residents are being trained to perform vaginal twin deliveries and that practicing clinicians are sufficiently competent and confident to manage the labor and delivery of such women (Carroll, 2006). The goal of this chapter is to present a well-illustrated approach to the vaginal delivery of twins. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - obgyn.mhmedical.com/content.aspx?aid=1138214659 ER -