DELIVERY OF TWINS

The delivery of twins presents considerable challenges to the obstetri c team, particularly in terms of decision-making, technical skills req uired and the need to respond quickly to changing circumstances. There is a serious lack of sound evidence upon which to base decisions conc erning the method of delivery of twins. The trend towards the routine use of caesarean section is not supported by evidence of improved outc ome for the infants, while maternal outcome is compromised. Specific c ircumstances that may have a bearing on the need for caesarean section include gestational age, presentation of the twins and chorionicity/a mnionicity. Caesarean section does not eliminate the chance of fetal t rauma during delivery, particularly for premature twins. The technique s of twin delivery, whether vaginal or by caesarean section, require t horough preparation for all possible eventualities, and skilled teamwo rk. Particular attention should be paid to emotional needs during labo ur, birth and afterwards, of the parents of twins.