Abdominal delivery of the second twin

In a series of 220 consecutive twin deliveries, 10 second twins were delivered by caesarean section after vaginal birth of the first, but only six survived. The mean time-interval between the birth of twins was 68 minutes. Because a protracted interdelivery interval carries risks of placental separation and cervical contraction, prompt trial of version of the second twin followed by vaginal breech extraction under anaesthesia might improve perinatal outcome.