IS IT NORMAL BIRTH OR CESAREAN IN TWIN PREGNANCIES?

Twin pregnancies, which make up approximately 1-2% of all pregnancies, have increased in the last decade. The main reason for the increase in twin pregnancies is the increase in IVF applications and other infertility treatments. In recent years, about a quarter of all twin pregnancies occur spontaneously. Half of them are due to in vitro fertilization applications and the remaining one fourth is related to treatments such as vaccination and ovulation induction.
Factors affecting normal delivery or cesarean option in twin pregnancies:
- One of the most important factors is the posture (situs) forms of babies. Twin babies enter the birth canal in turn, the first baby entering the channel with the head (vertex) increases the chance of normal birth. The fact that both babies are in the head-down position is the most preferred condition for normal delivery. If the first baby enters the canal with breech, normal delivery is not impossible. However, it is not preferred, mostly cesarean is preferred.
- Sometimes, although the first baby is born normally, the birth of the second baby may not be possible and cesarean surgery is performed for the second baby.
- How many weeks of gestation at the time of birth
- Estimated weight of babies: For very low birth weight twin babies (VLBW, below 1500 grams), some researchers suggest cesarean delivery but there is still no consensus.
- Developmental retardation in babies or other complications seen in twin pregnancies
- Mother having hypertension, diabetes and other systemic diseases
- Amniotic water supply (PPROM)
- Oligohydramnios, polyhydramnios
Today, depending on countries and hospitals, approximately 70-80% of twin babies are born by cesarean section. Even in some hospitals, routine cesarean is applied to almost all twin babies. There are several reasons for this increase, such as the fact that today most of the twin babies are obtained with IVF application and caesarean section is in the foreground.
In approximately 40% of twin pregnancies, both babies are in vertex position. In other words, both babies turned to the birth canal with head-down. These are the group in which normal birth is most successful. In 40% of twin pregnancies, although the first baby is head-down, the second baby is in the breech or transverse position. Normal delivery or cesarean decision can be made in this group. The remaining 20% ​​is such that both babies are not head-down, and caesarean is almost always preferred.
When does the birth take place in twin babies?
The duration of a normal singleton pregnancy is 40 weeks and mostly deliveries take place around 38-40 weeks. However, in twin pregnancies, births take place in earlier weeks. Approximately seventy percent of two pregnancies are born between 35-38 weeks of gestation.
Although there is no clear scientific consensus that twin babies should be delivered in the following week, in general, if there is no problem in pregnancy, delivery at 37-38 weeks is considered ideal for baby health. Some sources suggest that monochorionic (single common placenta) babies are delivered one week earlier.


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