title: Risk factors for emergency cesarean delivery of the second twin after vaginal delivery of the first twin.
abstract: OBJECTIVE
  A case-control study of twins was performed to identify clinical predictions of emergency cesarean delivery in the second-born twin after vaginal delivery of the first twin.
  
  
  METHODS
  The obstetric records were reviewed of all twin vaginal deliveries at the Japanese Red Cross Katsushika Maternity Hospital from 2002 through 2007.
  
  
  RESULTS
  There were 206 vaginal deliveries of first twins at >or=33 weeks of gestation. Of these deliveries, nine women (4.4%) underwent an emergency cesarean for the delivery of the second twin. The incidence of cesarean delivery for the second twin was significantly greater in cases with a history of infertility therapy (odds ratio: 5.0, 95% confidence intervals: 1.2-22), gestational age at >or=39 weeks (24, 4.7-120), nonvertex presentation (6.2, 1.5-26), operative delivery of the first twin (6.1, 1.5-24) and intertwin delivery time interval >30 min (7.2, 1.7-30).
  
  
  CONCLUSIONS
  The most important risk factor of emergency cesarean delivery in the second twin was a gestational age of >or=39 weeks.
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan. czg83542@mopera.ne.jp
authors.forename: Shunji
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D001238:Asphyxia Neonatorum; D001722:Birth Order; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004200:Diseases in Twins / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007746:Labor Presentation; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012099:Reproductive Techniques; D012307:Risk Factors; D014427:Twins