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Related Experiment Video

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Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators

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[Management of second twin delivery].

¹Hôpital Cochin, AP-HP, Maternité Port-Royal, 123, boulevard de Port-Royal, 75014 Paris, France. thomas.schmitz@cch.aphp.fr

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction

|February 10, 2010

Summary

Active management of second twin delivery is crucial for reducing intervals and associated risks. Optimal delivery mode depends on the second twin's presentation, often involving specific obstetrical maneuvers and resident training.

Area of Science:

Obstetrics and Gynecology
Perinatology
Maternal-Fetal Medicine

Context:

Delivery of the second twin presents unique challenges compared to singleton births.
Management strategies significantly impact neonatal outcomes and cesarean rates.
Evidence-based guidelines are needed to optimize second twin delivery.

Purpose:

To determine the optimal mode of delivery for the second twin based on presentation.
To evaluate strategies for minimizing inter-twin delivery intervals.
To reduce neonatal morbidity and cesarean delivery rates for the second twin.

Summary:

Active management of second twin delivery is recommended to shorten the inter-twin interval, reducing neonatal morbidity and cesarean rates.
For non-cephalic second twins, immediate breech extraction (after internal version for transverse lie) is preferred over external version.

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For cephalic second twins, delivery strategy varies based on station and provider expertise, with maneuvers like internal version and breech extraction potentially reducing cesarean rates.

Impact:

Provides evidence-based recommendations for optimizing second twin delivery.
Highlights the importance of specialized obstetrical maneuvers and resident training.
Aims to improve outcomes for both mother and neonate in twin gestations.