Little data is available correlating the in utero order of presentation and
the birth order of twins. Our objective was to determine whether birth ord
er in twin pregnancies corresponds to the order of presentation early in pr
egnancy. All twin pregnancies in which amniocentesis was performed from 199
6 to 1998 were identified. Those with discordant genders that delivered at
our hospital were included. Order of presentation was documented by ultraso
und at the time of amniocentesis. Delivery data were obtained from review o
f medical records. Statistical comparison was done using two-tailed Fisher'
s exact test, Student's t-test, and Mann-Whitney U test. Sixty patients met
inclusion criteria. Birth order corresponded to the order at the time of a
mniocentesis in 55 of 60 cases (91.7%). There was no difference in the rate
of concordance of prenatal and neonatal birth order in twins delivered vag
inally compared with those delivered abdominally (90.9 vs. 91.8%,p = 1.0).
Cases with discordant prenatal and neonatal birth order had similar materna
l ages, gestational ages at amniocentesis and delivery, and fetal presentat
ion at delivery as cases with concordant birth orders. In dichorionic twin
pregnancies, birth order is established early in gestation in > 90% of case
s regardless of route of delivery.