Combined vaginal-abdominal delivery of twins

During the five-year period 1977-1981, 120 twins were delivered at the University Hospital, Uppsala, Sweden. 6 or 5%, were delivered by the combined vaginal-abdominal route. There was no case of foetal death among the second twins. Only one second twin had an Apgar score of less than eight at five minutes. Four mothers received blood transfusion because of blood loss related to the operation and two mothers developed fever during the puerperium. It is concluded that caesarean section may well be performed for rapid delivery of the compromised second twin, although the maternal morbidity is substantial.