title: Delivery of the second twin.
abstract: OBJECTIVE
  To determine the likelihood of cesarean for the second twin after vaginal delivery of the first and the risk of vaginal delivery.
  
  
  METHODS
  A retrospective analysis of twin deliveries was performed on 10,365 live born twin pairs (20,730 births), using birth certificate data from the State of Illinois from 1997 through 2000.
  
  
  RESULTS
  The incidence of cesarean for the second twin after vaginal delivery of the first was 10.1%. The greatest incidence of failed vaginal delivery of the second twin was in the vertex/non-vertex group. Five-minute Apgar scores <4 were significantly more frequent in vaginally delivered twins <2000 g compared to those delivered via cesarean (p<0.001).
  
  
  CONCLUSIONS
  Twin presentation type is predictive of the likelihood of a failed vaginal delivery of the second twin. Cesarean appears to significantly reduce the incidence of Apgars <4 for neonates <2000 g.
authors.affiliation: Northwestern University Medical School, Chicago, IL, USA. cvsguy1@aol.com
authors.forename: N A
authors.initials: NA
authors.lastname: Ginsberg
authors.forename: E M
authors.initials: EM
authors.lastname: Levine
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007087:Illinois; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007746:Labor Presentation; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D012307:Risk Factors; D014427:Twins