RT Book, Section
A1 Yeomans, Edward R.
A1 Hoffman, Barbara L.
A1 Gilstrap III, Larry C.
A1 Cunningham, F. Gary
SR Print(0)
ID 1138214659
T1 Delivery of Twin Gestations
T2 Cunningham and Gilstrap's Operative Obstetrics, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071849067
LK obgyn.mhmedical.com/content.aspx?aid=1138214659
RD 2024/04/18
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.