title: [Modes of deliveries of twins as a function of their presentation. A study of 371 pregnancies].
abstract: OBJECTIVE
  In France, global rate of caesarian section in twin pregnancies has been 50.2% in 2003. Modes of delivery according to different twin presentations remain controversial in the literature. The purpose of our study is to analyze our practice of twin deliveries in a 5-year period, with neonatal outcomes.
  
  
  METHODS
  Among 22,243 women having delivered in our maternity (22 weeks and over) during the study period, the study population consisted of 371 twin pregnancies, of which 305 after 33 weeks gestation.
  
  
  RESULTS
  Different presentations were relatively identical whatever the gestational age of pregnancies: the "cephalic-cephalic" presentation represented 60 to 70% of the total, the "cephalic-breech" presentation approximately 10% while the "breech-cephalic" or "breech-breech" presentations approximately 8% each. Mean terms of pregnancies were 35.2 ± 2.8 weeks, mean birthweight being 2243 ± 561 g. C-section rate was 53.5%. When the first twin was in cephalic presentation, C-section rate was 40% while it was almost 100% when the first twin was in breech or "other" presentations.
  
  
  CONCLUSIONS
  There were no significant differences in neonatal outcomes (mean birthweights, Apgar scores, transfers in neonatology, perinatal deaths) according to different mode of deliveries (vaginal or C-sections). Our policy of planned cesarean section may need to be revised.
authors.affiliation: Service de gynécologie, CHR de Réunion, groupe hospitalier Sud-Réunion, BP 350, 97448 Saint-Pierre cedex, Île de Réunion. malik.boukerrou@chr-reunion.fr
authors.forename: M
authors.initials: M
authors.lastname: Boukerrou
authors.forename: P-Y
authors.initials: PY
authors.lastname: Robillard
authors.forename: P
authors.initials: P
authors.lastname: Gérardin
authors.forename: M
authors.initials: M
authors.lastname: Heisert
authors.forename: E
authors.initials: E
authors.lastname: Kauffmann
authors.forename: A
authors.initials: A
authors.lastname: Laffitte
authors.forename: G
authors.initials: G
authors.lastname: Barau
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D001946:Breech Presentation / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007746:Labor Presentation; D011247:Pregnancy; D011256:Pregnancy Outcome; D014427:Twins