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Twin gestation: fetal presentation as a function of gestational age
M Y Divon1, M J Marin, R N Pollack
1Weiler Hospital, Albert Einstein College of Medicine, Division of Montefiore Medical Center, Bronx, NY 10461.
American Journal of Obstetrics and Gynecology
|May 1, 1993
Summary
Spontaneous version in twin gestations decreases significantly after 30 weeks. Counseling on potential malpresentation resolution can help reduce cesarean delivery rates in twin pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatology
Background:
- Twin gestations present unique challenges in fetal positioning during the third trimester.
- Understanding spontaneous version rates is crucial for optimizing delivery management and reducing intervention rates.
Purpose of the Study:
- To evaluate the rate of spontaneous version in twin gestations throughout the third trimester.
- To determine the influence of gestational age on fetal presentation changes in twin pregnancies.
Main Methods:
- Serial ultrasonographic examinations were conducted on 119 consecutive patients with twin gestations.
- The incidence of spontaneous version was calculated as a function of gestational age.
Main Results:
- The incidence of spontaneous version decreased from 60% at 28-30 weeks to 25-30% at term.
- Cephalic-cephalic presentation showed the lowest incidence of spontaneous version (7%), with other presentations being unstable.
- Parity, birth weight discordancy, placental location, and amniotic fluid volume did not significantly affect spontaneous version rates.
Conclusions:
- Data on spontaneous version rates should be integrated into antepartum counseling for twin gestations.
- Awareness of potential malpresentation resolution may lead to a decreased cesarean delivery rate by informing clinical decisions before labor onset.