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Related Experiment Videos

Twin entanglement revisited.

R B Kurzel1

  • 1Department of Obstetrics and Gynecology, University of California, Los Angeles, USA.

Twin Research : the Official Journal of the International Society for Twin Studies
|March 3, 1999
PubMed
Summary
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Interlocking breech/vertex twins rarely occur, but vaginal delivery carries a higher entanglement risk. Cesarean section remains the primary management for these complex twin presentations.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Maternal-Fetal Medicine

Background:

  • High Cesarean section (C/S) rates in twin gestations are partly due to concerns about interlocking twins.
  • Breech (A)/vertex (B) (Br(a)/Vtx(b)) twin presentations pose unique management challenges.
  • Understanding the incidence of twin entanglement and interlocking is crucial for optimizing delivery modes.

Purpose of the Study:

  • To estimate the frequency of twin entanglement and interlocking in breech/vertex twin deliveries.
  • To analyze the incidence of interlocking and fetal collision in vaginal deliveries of Br(a)/Vtx(b) twins.
  • To evaluate the impact of delivery mode on perinatal outcomes in these specific twin presentations.

Main Methods:

  • Retrospective study of 541 twin deliveries and 48,195 total deliveries from 1987-1995.

Related Experiment Videos

  • Analysis of Br(a)/Vtx(b) twin incidence, mode of delivery, and reasons for Cesarean section.
  • Documentation of interlocking and collision events, and perinatal mortality.

    • Main Results:

    • Br(a)/Vtx(b) twins occurred in 7.9% of twin deliveries, with only 32.6% delivered vaginally.
    • One case of interlocking (2.3% of Br(a)/Vtx(b) pairs) and five cases of collision were observed, all requiring C/S.
    • The rate of interlocking in twins allowed vaginal delivery was 6.7%, while the overall rate remained low.

    Conclusions:

    • Breech/vertex twin presentation is at the highest risk for entanglement.
    • While overall interlocking rates are low, vaginal delivery of Br(a)/Vtx(b) twins shows a higher incidence.
    • Cesarean section remains the predominant delivery method for Br(a)/Vtx(b) twins, with no associated perinatal mortality in this series.