Timing and mode of delivery of twin pregnancy
Author(s): LI Jun-nan, QI Hong-bo, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University
Pages: 617-621
Year: 2015 Issue: 7
Journal: Chinese Journal of Practical Gynecology and Obstetrics
Keyword: twin pregnancy; mode of delivery; timing of delivery;
Abstract: The conduct of a twin delivery remains one of the most challenging events in the daily practice of obstetrics. Timing and mode of delivery of twins should be decided by gestational age, local medical level and maternal – fetal conditions( complicated twins,chorionicity,and so on),and individualized optimum mode and timing of delivery should be planned.Chorionicity is the most important determinant of pregnancy outcome in twin pregnancy. Induction of labor at 37 to 38weeks’ gestation should be routinedly considered in uncomplicated monochorionic twins.Uncomplicated dichorionic twins should be planned between 38 and39+ 6weeks of gestation. Complicated twins(monoamnionic twins, twin- to- twin transfusion sysdrome, selective intrauterine growth restriction, twin anemia polycythemia sequence)should be planned to havedelivery between 32 and 36 weeks.The indication for planned caesarean section in twin gestations include monoamniotic twins, conjoined twins other than at gestations remote from term, non-vertex twin A,and indications for singleton pregnancies;otherwise the above, planned vaginal delivery should be considered.
Pages: 617-621
Year: 2015 Issue: 7
Journal: Chinese Journal of Practical Gynecology and Obstetrics
Keyword: twin pregnancy; mode of delivery; timing of delivery;
Abstract: The conduct of a twin delivery remains one of the most challenging events in the daily practice of obstetrics. Timing and mode of delivery of twins should be decided by gestational age, local medical level and maternal – fetal conditions( complicated twins,chorionicity,and so on),and individualized optimum mode and timing of delivery should be planned.Chorionicity is the most important determinant of pregnancy outcome in twin pregnancy. Induction of labor at 37 to 38weeks’ gestation should be routinedly considered in uncomplicated monochorionic twins.Uncomplicated dichorionic twins should be planned between 38 and39+ 6weeks of gestation. Complicated twins(monoamnionic twins, twin- to- twin transfusion sysdrome, selective intrauterine growth restriction, twin anemia polycythemia sequence)should be planned to havedelivery between 32 and 36 weeks.The indication for planned caesarean section in twin gestations include monoamniotic twins, conjoined twins other than at gestations remote from term, non-vertex twin A,and indications for singleton pregnancies;otherwise the above, planned vaginal delivery should be considered.
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