Cesarean delivery for the second twin in the vertex-vertex presentation: Operative indications and predictability

Background. The incidence of second twin delivery by cesarean section and w hether obstetric parameters are predictive should be studied. Methods. In this retrospective study, all vertex-vertex twin deliveries dur ing a 48-month period were reviewed. Results. During the study period, 106 sets of vertex-vertex twins were iden tified. In 68 pairs, both were delivered vaginally (group 1), and 21 pairs were born via cesarean section. In the 17 pairs in group 2, the first infan t was delivered vaginally and the second by cesarean section because of fet al distress in 6 cases (35%), cord prolapse in 6 (35%), abnormal/unstable l ie in 4 (23%), and abruptio placenta in 1 case (6%). The only maternal fact or associated with abdominal delivery for twin B was greater maternal age. When cesarean delivery was required for twin B, a longer interval between d eliveries and a lower Apgar score were noted. Conclusion. Cesarean birth of twin B is a more common clinical event than p reviously reported but is not easily predicted by obstetric parameters.