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Changes in fetal presentation in twin pregnancies.
Stephen T Chasen1, Stacey J Spiro, Robin B Kalish
1Weill Medical College of Cornell University, Department of Obstetrics and Gynecology, New York, NY 10021, USA. stchasen@med.cornell.edu
Summary
Many twins experience spontaneous version in the third trimester. Fetal presentation at 32-36 weeks strongly correlates with birth presentation, indicating a high likelihood of cephalic presentation at delivery for twins presenting cephalic after 28 weeks.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Obstetrics
Background:
- Spontaneous version, the change in fetal position, is common in twin pregnancies.
- Understanding fetal presentation in the third trimester is crucial for delivery planning.
Purpose of the Study:
- To investigate the incidence of spontaneous version in twin pregnancies during the third trimester.
- To determine the correlation between antepartum and delivery fetal presentation in twins.
Main Methods:
- Twin pregnancies were grouped by gestational age (20-23, 24-27, 28-31, 32-36 weeks).
- Fetal presentation was classified as cephalic (C) or non-cephalic (NC).
- Statistical analyses, including chi-square and Cramer's V, were used to assess presentation distributions and correlations.
Main Results:
- Fetal presentation distributions varied significantly with gestational age (p < 0.001).
- Presentation at 32-36 weeks showed strong correlation with birth presentation (p = 0.75).
- No correlation was found between parity, gender, birthweight, or IVF and fetal presentation or spontaneous version rate.
Conclusions:
- Significant spontaneous version occurs in twins during the third trimester.
- Fetal presentation in twin pregnancies at 32-36 weeks is a reliable predictor of birth presentation.
- Cephalic presentation after 28 weeks gestation strongly predicts cephalic presentation at delivery.