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International
Delivery of Twins
Delivery of Twins
International
Objectives
Incidence
Types of presentation
Where to deliver
Mode of delivery
Management of labour
Delivery of Twins
International
Incidence
spontaneous twins occur in approximately
1 in 90 pregnancies
increased use of reproductive technology
has significantly increased this rate
Delivery of Twins
International
SECOND
TWIN
Breech
Other
Cephalic
39
13
0.6
Breech
26
0.6
Other
0.5
Delivery of Twins
International
Delivery of Twins
International
Delivery of Twins
International
Method of Delivery
consider the lie and presentation of each fetus
vaginal delivery is the goal unless there are
specific contraindications
placenta should not be drained and cord bloods
not taken until after delivery of second twin
Delivery of Twins
International
Delivery of Twins
International
Delivery of Twins
International
Delivery of Twins
International
Management of Labour
preterm labour common
educate re: warning signs
steroids indicated as in singleton
use tocolytics judiciously (pulmonary edema)
induction as per singleton indications plus twin
specific indications (e.g. EFW disparity)
augmentation as per singleton, may be helpful
following delivery of first twin
Delivery of Twins
International
Delivery of Twins
International