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Chapter 13 - Twin Delivery

Published online by Cambridge University Press:  16 October 2025

By
Soon Leong Yong  and
Tak Yeung Leung
Edited by
Sir Sabaratnam Arulkumaran
Sir Sabaratnam Arulkumaran
Affiliation:
St George's Hospital Medical School, University of London
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Summary

The twin birth rate has increased over the last four decades due to rising maternal age at conception and the use of assisted reproductive technology. Compared to singletons, twins, especially the second twin, are more susceptible to perinatal complications. However, current evidence suggests that in well-selected patients under skilled obstetricians’ care, planned vaginal delivery can be just as safe as planned caesarean delivery. This chapter elaborates on evidence-based information about selection criteria for vaginal twin delivery, timing of delivery and intrapartum management. Techniques for delivering vertex and nonvertex second twins and intertwin delivery intervals will also be discussed, along with addressing the associated controversies. Given the tendency of twin pregnancies to have preterm delivery, this chapter will also delve into the decision-making process for the mode of delivery in preterm twin gestations.

Keywords

twin deliveryvaginal deliveryintrapartum managementvertex second twinnonvertex second twinmaternal pushinginternal podalic versionexternal cephalic versionintertwin delivery intervalpreterm twins

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Chapter
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Best Practice in Labour and Delivery , pp. 159 - 171
Publisher: Cambridge University Press
Print publication year: 2025

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References

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