title: Is routine caesarean section necessary for breech-breech and breech-transverse twin gestations?
abstract: OBJECTIVE
  To determine if perinatal outcome is affected by the route of delivery in breech-breech and breech-transverse twin gestations.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Umtata General Hospital, a referral hospital for approximately 32 rural hospitals throughout the former transkei.
  
  
  METHODS
  Twin gestations with breech-breech and breech-transverse presentations.
  
  
  METHODS
  Birth weights, 5-minute Apgar scores and neonatal mortality rates among 41 women who underwent vaginal delivery were compared with those of 27 who underwent transverse lower-segment caesarean sections.
  
  
  RESULTS
  A total of 68 women were involved in the study. Forty-one were delivered vaginally and 27 underwent transverse lower-segment caesarean sections. The vaginal delivery group consisted of 35 breech-breech and 6 breech-transverse twin gestations, while the caesarean section group comprised 25 breech-breech and 2 breech-transverse presentations. Both twin I and twin II in the caesarean section group were bigger than their respective counterparts delivered vaginally (P < 0.02 for twin I and P < 0.01 for twin II). There were no statistically significant differences in either 5-minute Apgar scores or neonatal mortality rates between the two groups.
  
  
  CONCLUSIONS
  Vaginal delivery of breech-breech and breech-transverse twin gestations appears a reasonable option provided criteria for vaginal breech delivery are adhered to.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Transkei, Umtata, E. Cape.
authors.forename: J K
authors.initials: JK
authors.lastname: Essel
authors.forename: E T
authors.initials: ET
authors.lastname: Opai-Tetteh
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D001946:Breech Presentation; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007746:Labor Presentation; D011247:Pregnancy; D011446:Prospective Studies; D014427:Twins