Active Management of Labor's Second Stage Benefits Second Twin

Rates of twin births in the U.S. increased from 2.2% in 1990 to 3.2% in 2005; however, consensus is lacking about optimal delivery strategies. Researchers conducted a retrospective cohort study of outcomes for 287 sets of twins delivered at ≤38 weeks' gestation in a single academic practice that provided 24-hour pediatric and obstetric anesthesia coverage. All deliveries, whether planned cesarean (157 pregnancies) or planned vaginal (130 pregnancies), took place in an operating room; active management of second twins' births followed a strict protocol involving internal version and breech extraction, if necessary.

Among women in the planned vaginal group, 20 (15%) underwent cesarean delivery of both twins, and 110 (85%) delivered both twins …