Tayfun KUTLU, Elif BAĞLAM, Y. Sadiye EREN

İstanbul-Turkey

Management of labor in multiple pregnancies is one of the most attracting subjects of obstetrics. Presentation of twin pairs is the major determinant of the route of delivery. In the past how to deliver breech vertex twin pairs was a conflicting decision. Anesthesia, technical difficulties and antibiotic options restricted the use of cesarean section. Under such circumstances even sacrification of one of the babies could be acceptable and thus mortality and morbidity was high. Recently we prefer the abdominal route for delivery of breech vertex twins. Maternal morbidity is only slightly increased in cesarean sections when compared to vaginal delivery with the innovations of today. We now present a case of breech vertex twins which were interlocked during vaginal delivery and the first twin could be delivered up to the scapulas. The delivery of the first breech twin could be completed only after the abdominal delivery of the second vertex twin. The babies both did very well in contrast to their difficult delivery. This condition presented a chance for us to review the management of delivery of breech vertex twin pairs in the literature and to present our own clinical experience.

(Gynecol Obstet Reprod Med 2006; 12:000-000)

Key Words: Twins, Interlocking, Breech-vertex presentation