**Delivery**


[57] Doyle LW, Crowther CA, Middleton P, Marret S. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database of Systematic Reviews. 2007;(3):CD004661. DOI: 10.1002/14651858.CD004661.pub2. Review. Update

[58] Turitz AL, Too GT, Gyamfi-Bannerman C. Proximity of magnesium exposure to delivery and neonatal outcomes. American Journal of Obstetrics and Gynecology. 2016;**215**(4):508.

[59] Simhan HN, Himes KP. Neuroprotective Effects of in Utero Exposure to Magnesium Sulfate. Post TW, ed. Waltham, MA: UpToDate Inc. Available from: http://www.upto

in: Cochrane Database Syst Rev. 2009;(1): CD004661

date.com [Accessed: 15-09-2018]

208 Multiple Pregnancy - New Challenges

e1-508.e6. DOI: 10.1016/j.ajog.2016.05.004. Epub 2016 May 10

**Chapter 10**

**Provisional chapter**

**Time and Mode of Delivery in Twin Pregnancies**

**Time and Mode of Delivery in Twin Pregnancies**

DOI: 10.5772/intechopen.80092

There are many suitable recommendations for twin gestation term in the literature. In many protocols, resolution is recommended for dichorionic pregnancies around 38 weeks, at 36 weeks for monochorionic (devoid of complications) and at 32–34 weeks in cases of single amniotic chamber. The main risk associated with vaginal delivery is connected to the possibility of anoxia of the second twin. However, a cesarean delivery performed by non-cephalic presentation of the second twin is associated with increased maternal morbidity without improved neonatal outcome. The most important factors in the decision of the delivery mode include the presentation of the fetus, gestational age,

It is known that multiple pregnancy presents morbidity and mortality rates about 3–7 times

Among the difficulties in twin birth, we highlight: prematurity, non-cephalic presentations, dystocia, funicular prolapse, placental abruption, increased operative incidence, postpartum

In this chapter we will review the main aspects related to the time and mode of delivery in

greater than single pregnancies, and these are often determined in delivery care [1].

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

Eduardo Félix Martins Santana, Vivian Melo Corrêa,

Eduardo Félix Martins Santana, Vivian Melo Corrêa,

and weight or the weight difference between the fetuses.

**Keywords:** twin pregnancy, delivery, labor

hemorrhages, perinatal anoxia and tocotraumatism [2].

multiple pregnancies and issues related to fetal weight assessment.

Isabela Bottura and José Pedro Parise Filho

Isabela Bottura and José Pedro Parise Filho

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.80092

**Abstract**

**1. Introduction**

#### **Time and Mode of Delivery in Twin Pregnancies Time and Mode of Delivery in Twin Pregnancies**

DOI: 10.5772/intechopen.80092

Eduardo Félix Martins Santana, Vivian Melo Corrêa, Isabela Bottura and José Pedro Parise Filho Eduardo Félix Martins Santana, Vivian Melo Corrêa, Isabela Bottura and José Pedro Parise Filho

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.80092

#### **Abstract**

There are many suitable recommendations for twin gestation term in the literature. In many protocols, resolution is recommended for dichorionic pregnancies around 38 weeks, at 36 weeks for monochorionic (devoid of complications) and at 32–34 weeks in cases of single amniotic chamber. The main risk associated with vaginal delivery is connected to the possibility of anoxia of the second twin. However, a cesarean delivery performed by non-cephalic presentation of the second twin is associated with increased maternal morbidity without improved neonatal outcome. The most important factors in the decision of the delivery mode include the presentation of the fetus, gestational age, and weight or the weight difference between the fetuses.

**Keywords:** twin pregnancy, delivery, labor
