Time and Mode of Delivery in Twin Pregnancies

There are many suitable recommendations for twin gestation term in the literature. In many protocols, resolution is recommended for dichorionic pregnancies around 38 weeks, at 36 weeks for monochorionic (devoid of complications) and at 32–34 weeks in cases of single amniotic chamber. The main risk associated with vaginal delivery is connected to the possibility of anoxia of the second twin. However, a cesarean delivery performed by non-cephalic presentation of the second twin is associated with increased maternal morbidity without improved neonatal outcome. The most important factors in the decision of the delivery mode include the presentation of the fetus, gestational age, and weight or the weight difference between the fetuses.