Perinatal outcomes of twin pregnancies at term

A review of a two-year experience in our community disclosed that 57% of twin pregnancies (118/207) deliver at term. Little attention has been focused on perinatal outcomes of twin pregnancies remaining undelivered after 36 completed weeks. Therefore, we reviewed our experience to determine whether our practice should change to maximize perinatal care. Nearly all the study pregnancies (115/117, or 97.5%) delivered by the estimated date of confinement. Fetal malpresentation, failure to progress and the patient's lack of desire for a vaginal birth after cesarean delivery were common reasons for the high cesarean rate (62/117, or 52%). The neonatal outcomes were favorable regardless of the route or interval between deliveries. Discordant fetal growth was found in only eight cases (6.8%). No perinatal deaths occurred, and five-minute Apgar scores less than 7 (2/234, or 0.9%) and rates of anomalies (5/234, or 2.1%) were not different from those in singleton pregnancies delivering during the same period. Using the principles of obstetric practice used in our community, we would expect the perinatal outcomes in term twin gestations to be favorable.