Caesarean delivery for the second twin

Date

2011

Authors

Crowther, C.

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Cochrane Database of Systematic Reviews, 2011; 12(12):47-47

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C.A. Crowther

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Abstract

<h4>Background</h4>The optimal mode of birth for a second twin in breech position is controversial, with support for both caesarean and vaginal birth.<h4>Objectives</h4>The objective of this review was to assess the effects of caesarean birth compared with vaginal birth of a second twin not presenting cephalically.<h4>Search methods</h4>The Cochrane Pregnancy and Childbirth Group's Trials Register and bibliographies up to 31 January 2007.<h4>Selection criteria</h4>Randomised trials of caesarean birth compared with vaginal birth in women with a twin pregnancy where the second twin is not presenting cephalically.<h4>Data collection and analysis</h4>All assessments of trial eligibility, quality and data extractions were done by the author without blinding.<h4>Main results</h4>One trial involving 60 pairs of twins was included. Maternal febrile morbidity were increased in women allocated to the caesarean group (relative risk (RR) 3.67, 95% confidence interval (CI) 1.15-11.69), and there was a trend to an increased need for use of general anaesthesia (RR 2.40, 95% CI 0.98-5.88). No differences were detected in neonatal outcome.<h4>Authors' conclusions</h4>Caesarean section for the birth of a second twin not presenting cephalically is associated with increased maternal febrile morbidity with, as yet, no identified improvement in neonatal outcome. This policy should not be adopted except within the context of further controlled trials.

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This review has been withdrawn from publication because it has been replaced and updated by a new review entitled 'Planned caesarean section for women with a twin pregnancy'. http://hdl.handle.net/2440/71504

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Copyright © 2011 The Cochrane Collaboration.

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