Lumbar epidural analgesia for labor and delivery of twins

In this study we examined the effects on mother and infants of epidural analgesia for labor and delivery of twins. Fourteen women with twins received lumbar epidural analgesia. Maternal radial artery and umbilical vessel blood-gas and acid-base measurements together with Apgar scores were determined. Resulting values were compared to those of women receiving epidural analgesia for labor and delivery of one infant. Apgar scores and blood-gas values for first twins were virtually the same as for singleton controls. Our small series confirms the problem of second-twin compromise, but this was minimal and was more pronounced in nonvertex presentations, as would be expected. We believe there is much to recommend lumber epidural analgesia for labor and delivery of twins, and that it is a safe form of analgesia in this situation.