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Excessive use of cesarean section for the second twin?
1Department of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital, Sweden. kerstin.wolff@obgyn.hs.sll.se
Gynecologic and Obstetric Investigation
|July 15, 2000
Summary
Cesarean section rates for the second twin after vaginal birth of the first twin are high but often avoidable. Vaginal delivery is recommended for twin pregnancies when possible.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Cesarean section rates for second twins after vaginal birth of the first twin have increased in Sweden.
- Twin deliveries present unique challenges in obstetric management.
Purpose of the Study:
- To investigate the indications for cesarean sections in second twins.
- To compare cesarean section rates for second twins at a university hospital with national data.
Main Methods:
- Retrospective review of all twin deliveries at Huddinge University Hospital (1995-1997).
- Comparison of local cesarean section rates with the Swedish Medical Birth Register.
Main Results:
- Cesarean section for the second twin occurred in 11% of deliveries.
- Two-thirds of these cesarean sections were deemed potentially avoidable.
- Overall twin cesarean section rates were 45% locally and 44% nationally.
Conclusions:
- Vaginal delivery is supported for normal twin pregnancies due to favorable fetal outcomes and reduced maternal risks.
- Interventions like extraction or version for a nonvertex second twin are recommended before resorting to cesarean section.
