engleski

Timing and the mode of delivery of twin pregnancy

About 2 – 3% of all pregnant women are expecting twins. Together, with all complications that my arise from the multiple pregnancy in general, there is an uncertainty about the best mode of delivery and the timing for delivery for twin pregnancy. There is a huge gap in our knowledge about the best approach to delivering twins As well as that, twin pregnancies near term, have higher rates of complications than pregnancies with only one baby. These complications might arise because of problems during pregnancy or during birth. Both twins may be at risk but birth complications more often happen for the second twin after the delivery of the first twin. Still, many doctors believe that women giving birth to twins when the first twin is coming head first, may safely give birth vaginally, with only a very low risk of serious problems (less than 5 in 1000 having a significant problem at the time of the birth). Therefore, despite clear indications for caesarean section, there is still a doubt about the benefits or otherwise regarding the mode of delivery when the first twin is in cephalic presentation at term. There has been one randomized controlled trial (RCT) of planned CS vs. planned vaginal birth (VB) for twins: the sample size was too small to answer the question of the better approach to delivery. A Cochrane review has recommended that a larger RCT be undertaken. Such multicentre international RCT, comparing planned CS to planned VB for twins at 32 - 38 weeks gestation is presently under way by Maternal Infant and Reproductive health research unit, University of Toronto, Canada.

tein pregnancy; delivery

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