[Twin delivery: a survey of French obstetrical policies].
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.
Vendittelli
F
F
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
Rivière
O
O
Pons
J-C
JC
Lémery
D
D
Berrebi
A
A
Mamelle
N
N
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