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Intrapartum external version of the second twin.

F A Chervenak, R E Johnson, R L Berkowitz

    Obstetrics and Gynecology
    |August 1, 1983
    PubMed
    Summary
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    External cephalic version (ECV) is effective for malpositioned second twins, with high success rates for transverse and breech presentations. This procedure can lead to vaginal delivery, potentially avoiding cesarean sections.

    Area of Science:

    • Obstetrics and Gynecology
    • Perinatology
    • Maternal-Fetal Medicine

    Background:

    • Malpresentation of the second twin complicates vaginal delivery.
    • External cephalic version (ECV) is a procedure to externally reposition a fetus.
    • The efficacy and safety of ECV for second twins require further evaluation.

    Purpose of the Study:

    • To assess the success rate of external cephalic version (ECV) in second twins with abnormal presentations.
    • To identify factors associated with successful ECV in this population.
    • To evaluate the impact of ECV on subsequent vaginal delivery and neonatal outcomes.

    Main Methods:

    • Twenty-five external cephalic versions (ECVs) were attempted on second twins in transverse or breech presentations.
    • Data collected included presentation, parity, gestational age, birth weight, anesthesia, twin size disparity, and Apgar scores.

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  • Outcomes analyzed were successful version, vaginal delivery, and neonatal well-being.

    • Main Results:

    • Successful ECV was achieved in 71% of transverse and 73% of breech presentations.
    • Success was associated with anesthesia type and twin size disparity, but not parity, gestational age, or birth weight.
    • Apgar scores below 7 at 1 and 5 minutes were observed in 28% and 8% of neonates, respectively. One neonatal death occurred.

    Conclusions:

    • External cephalic version (ECV) is a viable option for managing second twins with abnormal presentations, potentially reducing the need for cesarean delivery.
    • Further research is needed to confirm the safety and efficacy of ECV, particularly in lower birth weight infants.