MODE OF DELIVERY IN TWIN PREGNANCY

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Velena Radošević

Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb

Key words: twin pregnancy, delivery of twins
SUMMARY. Delivery should be planned between 38 to 39 weeks of pregnancy for dichorionic/diamniotic twins. Delivery
of monochorionic/diamniotic twins is best to plan between 36 to 37 weeks. For cephalic–cephalic position of the twins
we suggest vaginal delivery in the absence of standard indications for cesarean delivery and when the fi rst twin is not in
cephalic position we suggest cesarean delivery. For cephalic – noncephalic twins, suggestion is trial of labor and breech
extraction of the second twin. Available data are reassuring that outcomes in women with twins attempting vaginal birth
after a previous cesarean delivery are similar to those with singletons undergoing a trial of labor. However, these data
are insuffi cient to defi nitively establish that the uterine rupture rates are comparable. After the delivery of the fi rst twin,
the heart rate and position of the second twin should be evaluated. As long as the fetal heart rate tracing is reassuring,
there is no duration of elapsed time from delivery of the fi rst twin necessitates intervention to deliver the second twin.