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http://apecguidelines.org/wp-content/uploads/2016/07/APEC-TWIN-6-2017.pdf
candidates for twin vaginal delivery, may be considered candidates for a trial of labor after cesarean delivery. (ACOG, 2016) • Provide nutrition education for 3000 Kcal/day and supplement diet with 60 -100 mg/day of elemental iron (ferrous sulfate 325 mg/day) and 1 mg/day of folic acid.
https://www.obgproject.com/2019/01/30/acog-recommendations-when-to-deliver-medically-complicated-pregnancies/
With less extensive surgery, delivery may be considered as late as 38w6d ACOG states Timing of delivery should be individualized based on prior surgical details (if available) and the clinical situation
https://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co745.pdf?dmc=1
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https://www.aapc.com/discuss/threads/billing-for-twin-deliveries.1973/
Jan 26, 2008 · The preferred method of reporting a vaginal delivery of twins, when the global obstetrical care is provided by one physician is by appending modifier 22 to the routine obstetric care including antepartum care, delivery and postpartum care.
https://www.contemporaryobgyn.net/acog-annual-meeting/intrapartum-management-second-twin
He counsels families that if the first twin is breech, both twins are delivered by cesarean. But if the first twin is head down, a vaginal delivery is planned for both twins, unless there is a good reason not to do so, such as the second twin being much larger than the first. “We also factor in …Author: Bob Kronemyer
https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/for-medical-professionals/twin-pregnancy-obstetric-care-guidelines
Because women carrying twins are at an increased risk of developing anemia, the Society of Maternal-Fetal Medicine recommends 30 milligrams of iron during the first trimester and 60 milligrams of iron until delivery.
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