Planned Caesarean Section for Women with a Twin Pregnancy

Summary

A Cochrane review [Abstract] 1 included 2 studies with a total of 2864 women. Most of the data were from a multicentre trial where 2804 women were randomised in 106 centres in 25 countries. First twin was in cephalic presentation. There was no difference between the planned caesarean section group or planned vaginal birth group for maternal death or serious morbidity (RR 0.86, 95% CI 0.67 to 1.11; 2 trials, n=2844; moderate quality evidence) or for perinatal or neonatal death or serious neonatal morbidity (RR 1.15, 95% CI 0.80 to 1.67; 1 trials, n=5565 babies, moderate quality evidence). No studies reported childhood disability.For secondary outcomes there was no clear evidence of differences between groups for perinatal or neonatal mortality, serious neonatal morbidity, or any of the other neonatal outcomes reported.Most women in the planned caesarean group had treatment as planned (90.9% underwent caesarean section), whereas in the planned vaginal birth group 42.9% had caesarean section for at least one twin. There were no significant differences between groups for failure to breastfeed or the number of women with scores greater than 12 on the Edinbugh postnatal depression scale.