title: [Twin delivery: a survey of French obstetrical policies].
abstract: OBJECTIVE
  To describe obstetrical policy variations concerning the delivery management in the case of twins, at term.
  
  
  METHODS
  A mail survey was undertaken among the medical supervisors of the maternity wards belonging to the AUDIPOG Network (N=170).
  
  
  RESULTS
  The participating rate was 73.35%. 124 answers were analysed. Elective caesarean was realized by 0.8% of participants for diamniotic twins and by 57% of cases for monamniotic twins An elective caesarean is planned for respectively 74% of answers if first (J1) and second twin (J2) are in a breech presentation, 81% if J1 is in breech and J2 in cephalic presentation, and 68% if J1 is in breech and J2 in transverse presentation. Delivery with J1 in breech and J2 in cephalic presentation had a higher risk than a delivery of a single breech at term. When J1 and J2 had a breech presentation 73% of participants thought that this delivery is more difficult than a delivery of a single breech at term. However, they were only 17.5% to consider that a delivery of twin with J1 in cephalic and J2 in breech presentation had a higher risk than a single breech delivery.
  
  
  CONCLUSIONS
  Medical policy variations are not extensive except for X-ray pelvimetry and the presence for the delivery of one paediatrician and one anaesthesiologist. An elective caesarean policy for twins is infrequent in France.
authors.affiliation: Fédération de gynécologie-obstétrique, CHU de Clermont-ferrand, maternité de L'Hôtel-Dieu, boulevard Leon-Malfreyt, Clerrmont-Ferrand cedex 01, France. fvendittelli@chu-clermontferrand.fr
authors.forename: F
authors.initials: F
authors.lastname: Vendittelli
authors.forename: O
authors.initials: O
authors.lastname: Rivière
authors.forename: J-C
authors.initials: JC
authors.lastname: Pons
authors.forename: D
authors.initials: D
authors.lastname: Lémery
authors.forename: A
authors.initials: A
authors.lastname: Berrebi
authors.forename: N
authors.initials: N
authors.lastname: Mamelle
mesh_terms: D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D009774:Obstetrics / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011256:Pregnancy Outcome; D011795:Surveys and Questionnaires; D014427:Twins; D014710:Version, Fetal