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Selected intrapartum external cephalic version of the second twin
1Georgetown University Hospital School of Medicine, Washington, DC.
Obstetrics and Gynecology
|March 1, 1992
Summary
External cephalic version (ECV) is a safe procedure for repositioning malpositioned second twins, increasing the likelihood of vaginal delivery. This method shows promise for managing twin gestations with abnormal presentations.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Malpresentation of the second twin in twin gestations poses delivery challenges.
- Cesarean delivery is often considered for second twins with abnormal presentations.
Purpose of the Study:
- To evaluate the efficacy and safety of external cephalic version (ECV) for malpositioned second twins.
- To determine if ECV can increase the rate of vaginal delivery in twin gestations.
Main Methods:
- External cephalic version was attempted on 30 second twins with transverse or breech presentations after the delivery of twin A.
- Success rates were analyzed based on initial presentation (transverse vs. breech).
- Neonatal outcomes, including Apgar scores, were assessed.
Main Results:
- Successful version was achieved in a significant proportion of cases, leading to vertex vaginal delivery for most.
- Success was not significantly associated with maternal parity or infant birth weight.
- The procedure demonstrated a good safety profile, with only one infant having a low 1-minute Apgar score.
Conclusions:
- External cephalic version is a useful and safe option for managing second twins with abnormal presentations.
- ECV may reduce the need for routine cesarean deliveries in selected twin gestations.
- Further research and technique refinement could enhance ECV success rates for second twins.