TWIN GESTATION - FETAL PRESENTATION AS A FUNCTION OF GESTATIONAL-AGE

OBJECTIVE: Our objective in this study was to evaluate the rate of spo ntaneous version in twin gestation throughout the third trimester. STU DY DESIGN: Serial ultrasonographic examinations were performed on 119 consecutive patients with twin gestation. The incidence of spontaneous version as a function of gestational RESULTS: The mean birth weight a nd gestational age at delivery were 2640 gm and 37 weeks, respectively . Nineteen percent had birth weight discordancy, and 37% were delivere d by cesarean section. The incidence of spontaneous version decreased from 60% at 28 to 30 weeks' gestation to 25% to 30% at term. The lowes t incidence of spontaneous version was observed in pregnancies with a cephalic-cephalic presentation (7%). All other presentations were rela tively unstable. Neither the patients' parity nor the presence of birt h weight discordancy, the placental location, or the amniotic fluid vo lume had a significant association with the incidence of spontaneous v ersion. CONCLUSION: These data should be incorporated into the routine antepartum counseling of patients with twin gestation. Their use in t his capacity may result in a decreased cesarean delivery rate if clini cians realize that malpresentations may spontaneously resolve before t he onset of labor.