Skip to main content
SpringerLink
Log in

Twin Gestation and Multiple Births

  • Chapter
Cesarean Section

Part of the book series: Clinical Perspectives in Obstetrics and Gynecology ((CPOG))

  • 132 Accesses

Abstract

The incidence of twins, triplets, and high-order multifetal pregnancies has increased significantly since the introduction of artificial stimulation of ovulation and in vitro fertilization.1 These pregnancies are at a higher risk than singletons for perinatal morbidity and mortality. Although much has been written about the mode of delivery for these gestations, there is little consensus over whether cesarean section improves the outcome. Despite little evidence to support cesarean section for multiple gestations, the cesarean section rate has increased from 3% in 1972 to 51% in 1985.2 The cesarean rate for triplets increased from 16% in 1977 to almost 94% in 1988.3 The purpose of this chapter is to discuss the management of multiple gestations and to make recommendations concerning possible modes of delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Holberg G, Biale Y, Lewenthal H, Insler V. Outcome of pregnancy in 31 triplet gestations. Obstet Gynecol 1982;59:472.

    Google Scholar 

  2. Bell D, Johansson D, McLean FH, Usher RH. Birth asphyxia, trauma and mortality in twins: has cesarean improved outcome? Am J Obstet Gynecol 1986;167:901.

    Google Scholar 

  3. Creinin M, Katz M, Laros R. Triplet pregnancy: changes in morbidity and mortality. J Perinatol 1991;11:207.

    PubMed  CAS  Google Scholar 

  4. Greig P, Veille J-C, Morgan T, Henderson L. The effect of presentation and mode of delivery on neonatal outcome in the second twin. Am J Obstet 1992;167:901.

    CAS  Google Scholar 

  5. Marivate M, Norman RJ. Twins. Clin Obstet Gynaecol 1982;9:783.

    Google Scholar 

  6. Kohl SG, Casey G. Twin gestation. Mt Sinai J Med 1975;42:523.

    PubMed  CAS  Google Scholar 

  7. Chervenak FA. The controversy of mode of delivery in twins: the intrapartum management of twin gestation (Part II). Semin Perinatol 1986;10:44.

    PubMed  CAS  Google Scholar 

  8. Cetrulo CL. The controversy of mode of delivery in twins: The intrapartum management of twin gestation (Part I). Semin Perinatol 1986;10:39.

    PubMed  CAS  Google Scholar 

  9. Chervenak F, Johnson R, Voucha S, Hobbins J, Berkowitz R. Intrapartum management of twin gestation. Obstet Gynecol 1985;65:119.

    PubMed  CAS  Google Scholar 

  10. Rabinovici J, Barkai G, Reichman B, Serr DM, Mashiach S. Randomized management of the second nonvertex twin: vaginal delivery or cesarean section. Am J Obstet Gynecol 1987;156:52.

    PubMed  CAS  Google Scholar 

  11. Tchabo JG, Tomai T. Selected intrapartum external cephalic version of the second twin. Obstet Gynecol 1992;79:421.

    Article  PubMed  CAS  Google Scholar 

  12. Trofalter KF. Management of delivery. Clin Perinatol 1988;15:93.

    Google Scholar 

  13. Wells S, Thorp J, Bowes W. Management of the second nonvertex twin. Surgery 1991:172.

    Google Scholar 

  14. Fisherman A, Grubb D, Kovacs B. Vaginal delivery of the nonvertex second twin. Am J Obstet Gynecol 1993;168:861.

    Google Scholar 

  15. Adam C, Allen AC, Baskett TF. Twin de- livery: influence of presentation and method of delivery on the second twin. Am J Obstet Gynecol 1991;165:23.

    PubMed  CAS  Google Scholar 

  16. Barrett J, Staggs SM, Van Houydonk JE, Growden JH, Killam AP, Boehm F. The effect of type of delivery upon neonatal outcome in premature twins. Am J Obstet Gynecol 1982;143:360.

    PubMed  CAS  Google Scholar 

  17. Rydstrom H, Ingemarrson I. A case control study of the effects of birth by cesarean section on intrapartum and neonatal mortality among twins weighing 1500–2400 gm. Br J Obstet Gynaecol 1991;98:249.

    Article  Google Scholar 

  18. Cetrulo CL, Ingardia CL, Sbarra AJ. Management of multiple gestation. Clin Obstet Gynecol 1990,23:533.

    Google Scholar 

  19. Kelsick F, Minkoff H. Management of the breech second twin. Am J Obstet Gynecol 1982;144:873.

    Google Scholar 

  20. Khanda S. Locked twins. Obstet Gynecol 1972;39:453.

    Google Scholar 

  21. Gabbe S, Neibyl J, Simpson J. Obstetrics, normal and abnormal pregnancies, 2nd Ed. New York: Churchill Livington, 1991.

    Google Scholar 

  22. Rodis JF, Vintzileos AM, Campbell DJ. Antenatal diagnosis and management of monoamniotic twins. Am J Obstet Gynecol 1987;157:1255–1257.

    PubMed  CAS  Google Scholar 

  23. Carr SR, Aronson MP, Coustan DR. Survival rates of monoamniotic twins do not increase after 30 weeks’ gestation. Am J Obstet Gynecol 1990;163:719–722.

    PubMed  CAS  Google Scholar 

  24. Tessen J, Zlatnick F. Monoamniotic twins: a retrospective controlled study. Obstet Gynecol 1991;77:832.

    PubMed  CAS  Google Scholar 

  25. James JN, Berbos BF, King A. Quintuplet pregnancy. JAMA 1964;188:113.

    Google Scholar 

  26. Caspi E, Ronen J, Schreyer P. The outcome of pregnancy after gonadotropin therapy. Br J Obstet Gynaecol 1976;83:967.

    Article  PubMed  CAS  Google Scholar 

  27. Loucopoulos A, Jewelewic Z. Management of multifetal pregnancies: sixteen years’ experience at the Sloan Hospital for Women. Am J Obstet Gynecol 1982;143:902.

    PubMed  CAS  Google Scholar 

  28. Ron-El R, Eliahu C, Schreyer P, Weinraub Z, Arleli S, Goldberg M. Triplet and quadruplet pregnancies and management. Obstet Gynecol 1981;57:458.

    PubMed  CAS  Google Scholar 

  29. Itzkowic D. A survey of 59 triplet pregnancies. Br J Obstet Gynaecol 1979;86: 23.

    Article  PubMed  CAS  Google Scholar 

  30. Deale CJC, Cronje HS. A review of 367 triplet pregnancies. S Afr Med J 1984;66: 92.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Cornelia R. Graves
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frank H. Boehm
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Kaiser Permanente, Southern California Permanente Medical Group, 92505, Riverside, CA, USA

    Bruce L. Flamm M.D. (Research Chairman) (Research Chairman)

  2. Department of Obstetrics and Gynecology, University of California-Irvine Medical Center, 92668, Orange, CA, USA

    Edward J. Quilligan M.D. (Professor Emeritus) (Professor Emeritus)

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag New York, Inc.

About this chapter

Cite this chapter

Graves, C.R., Boehm, F.H. (1995). Twin Gestation and Multiple Births. In: Flamm, B.L., Quilligan, E.J. (eds) Cesarean Section. Clinical Perspectives in Obstetrics and Gynecology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2482-2_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-2482-2_9

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7556-5

  • Online ISBN: 978-1-4612-2482-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation