title: Delivery of the second twin.
abstract: The course of twin pregnancy is most amenable to positive intervention during the antepartal period. However, once a laboring woman arrives on the labor floor, there is still opportunity to influence outcome. The management of multiple gestation is best accomplished through use of a multidisciplinary team. Intrapartal events are handled with greater confidence when each member of the team is aware not only of his or her specific role, but also of all the tasks that need to be accomplished. Rehearsal prior to the delivery and communication during the delivery are essential. Each team member can positively affect the outcome in twin delivery through the use of unique skills. The preceding review of the literature regarding multiple gestation during labor portrays the dilemmas and controversies surrounding management. It is incumbent on all maternity staff to become acquainted with the issues and acquire the skills necessary to render safe care. Every complication of labor and delivery, including preterm labor, uterine dysfunction, abnormal presentation, prolapse of the umbilical cord, premature separation of the placenta, and immediate postpartum hemorrhage, occurs with greater frequency with multiple gestation. Therefore, the conduct of labor and delivery with twins is an excellent challenge to the skills of the team that provides care for the patient and her fetuses.
authors.forename: V M
authors.initials: VM
authors.lastname: Jackson
mesh_terms: D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010343:Patient Admission; D010348:Patient Care Team; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011295:Prenatal Care; D014427:Twins