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https://www.sciencedirect.com/science/article/pii/S0146000512000171
Obstetrical management decisions related to the delivery of twins ultimately focus on minimizing stillbirth and neonatal morbidity and mortality risks. Randomized controlled studies on these issues are unfortunately limited. Therefore, decisions on the delivery of twins …Author: Young Mi Lee
https://www.contemporaryobgyn.net/acog-annual-meeting/intrapartum-management-second-twin
A practical, hands-on approach to intrapartum management of the second twin was presented at the 2018 Annual ACOG Meeting in Austin. “Although the literature about the delivery of twins is understandably limited, we believe that vaginal delivery is generally a safe thing to do,” said Julian Robinson, MD, chief of obstetrics at Brigham and Women’s Hospital.Author: Bob Kronemyer
https://www.uptodate.com/contents/twin-pregnancy-labor-and-delivery#!
Twin pregnancies are at increased risk of late stillbirth and intrapartum complications, such as fetal heart rate abnormalities and complications related to malpresentation or placentation.
https://www.twin-pregnancy-and-beyond.com/twin-pregnancy-labor-and-delivery.html
Many physicians recommend delivery of twins by 38 weeks. And in fact, many women carrying twins do go into labor naturally during this time. However, when a twin pregnancy goes too long there is a possibility of depletion of the placenta which may lead to devastating consequences.
https://www.glowm.com/section_view/heading/Multiple%20Gestation:%20Labor%20and%20Delivery/item/140
Requisite personnel for a twin delivery should comprise the following: two qualified birth attendants ( i.e., two obstetricians or an obstetrician-midwife team); an anesthesiologist with an assistant if required; two neonatal resuscitation teams; and, finally, qualified sonographic assistance.
https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/for-medical-professionals/twin-pregnancy-labor-and-delivery-guidelines-for-medical-professionals
The optimal mode of delivery depends on a variety of factors, including: The type of twins; Fetal positions; Gestational age; Fetal size; The obstetric care provider’s experience; Mo-Mo twins should always be delivered by cesarean section to avoid umbilical cord complications for the non-presenting twin at the time of the first twin’s delivery.
https://www.stanfordchildrens.org/en/topic/default?id=care-and-management-of-multiple-pregnancy-85-P08022
Delivery of multiples depends on many factors including the fetal positions, gestational age, and health of mother and fetuses. Generally, in twins, if both fetuses are in the vertex (head-down) position and there are no other complications, a vaginal delivery is possible.
https://www.whattoexpect.com/pregnancy/twins-and-multiples/giving-birth/multiple-birth-experience.aspx
Jan 30, 2015 · Vaginal delivery. About 40 percent of twins born these days come into the world the old-fashioned way, but that doesn’t mean the birthing experience is the same as it is for singleton moms. Once you’re fully dilated, delivery of Baby A may be a piece of cake (“Three pushes was all it took!”) or a protracted ordeal (“It took five hours!”).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252881/
Proponents of planned cesarean delivery of late preterm and term twins often cite the same four studies. 9 – 12 One study performed in Scotland examined 4707 twin pregnancies. 9 The study goal was to determine if second twins are at an increased risk of perinatal death due to labor and delivery complications. In this study, 454 women at term underwent planned cesarean delivery.Author: Diane Christopher, Barrett K Robinson, Alan M Peaceman
http://residents.fammed.org/Manuals/OB%20Book/TWIN%20DELIVERY%20GUIDELINES%202007.pdf
intrapartum management: The team for twin deliveries consists of FM residents and staff, OB residents and staff, neonatal intensive care staff, anesthesiologist and two nurses on site in the delivery room.
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