External cephalic version for a malpresenting first twin before labor: a prospective case series.

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics
• Perinatal Research

Background:

• Cesarean delivery is standard for twin pregnancies with a non-cephalic presenting twin.
• External cephalic version (ECV) is established for malpresenting singleton pregnancies but is poorly studied in twins.
• Limited data exists on the safety and efficacy of ECV in twin gestations.

Purpose of the Study:

• To evaluate the feasibility of performing external cephalic version (ECV) on a malpresenting first twin before labor.
• To document any complications associated with ECV in twin pregnancies.
• To assess secondary outcomes including delivery characteristics and neonatal well-being.

Main Methods:

• Prospective cohort study of twin pregnancies with a malpresenting first twin.
• ECV performed following institutional singleton protocols; fetal testing before and after.
• Inclusion criteria: English/Spanish speaking; Exclusions: contraindications to vaginal delivery.

Main Results:

• Four out of five patients (80%) successfully underwent ECV.
• Vaginal delivery occurred in 2 of the 4 patients with successful ECV.
• No maternal or neonatal complications were observed in any participants.

Conclusions:

• External cephalic version (ECV) appears feasible for twin pregnancies with a malpresenting first twin.
• The procedure was associated with no complications in this cohort.
• Further research is required to fully characterize the safety and efficacy of ECV in this population.