The maternal-fetal medicine specialists at Brigham and Women’s Hospital (BWH) compiled the following labor and delivery guidelines for a twin pregnancy. These guidelines are based on the combined knowledge and experience of BWH’s maternal-fetal medicine specialists, current research and professional society guidelines.
Below are recommendations regarding the optimum time for admission and delivery for an uncomplicated twin pregnancy.
A twin gestation in and of itself does not necessitate a cesarean delivery. The optimal mode of delivery depends on a variety of factors, including:
Mo-Mo twins should always be delivered by cesarean section to avoid umbilical cord complications for the non-presenting twin at the time of the first twin’s delivery.
A recent randomized trial of Di-Di and Mo-Di twin births indicated that for uncomplicated pregnancies between 32-38 6/7 weeks with a presenting vertex twin, a planned cesarean delivery did not decrease the risk of fetal or neonatal death, or serious neonatal morbidity, compared with a planned vaginal delivery. *
A woman carrying Di-Di or Mo-Di twins is a good candidate for a vaginal birth if:
If your patient had a prior cesarean section, she may still be a good candidate for delivering twins vaginally. Read more about VBAC deliveries.
* A Randomized Trial of Planned Cesarean or Vaginal for Twin Pregnancy,” New England Journal of Medicine, October, 2013.
In addition to a woman’s routine care from her obstetrician, consultation with and additional care from a maternal-fetal medicine specialist is recommended in different cases
The maternal-fetal medicine specialists at BWH are always happy to answer questions or provide a consult. You can send a question via email or call us directly.
Phone: (617) 732-5452
Phone: (617) 732-5445
We are happy to respond to general questions about twin pregnancies. Please use our online form to send us your twin pregnancy question, and one of our maternal-fetal medicine specialists will respond. Please note that your question will be emailed and responded through a private and secure system.
Access research and information about twin gestation and delivery.
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Read more about maternal-fetal medicine at Brigham and Women’s Hospital.
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