Management of Twin Labor

Abstract

Investigations were carried out on 68 labors in twin pregnancies. It was observed that, upon stimulation of uterine contractions by means of oxytocic agents, mainly oxytocin (90%), the mean duration of labor was significantly reduced to about 7 hours, and prolonged labors (over 20 hours) were completely eliminated. The time between delivery of the first and the second baby is now below 30 minutes in all cases, and this is regarded as the optimum time. No neonatal deaths were observed in labors taking place at term. The condition of the newborns at birth was estimated in accordance with the Apgar score and it was found that the second newborn scored worse than the first one; a fact definitely related to the higher proportion of operative procedures during delivery of the second twin (48%) as compared to the first one (10%).

The authors stress that, owing to the introduction of the method of conducting twin labors, maternal mortality has been completely eliminated and twin perinatal mortality has been markedly reduced: from about 28% in 1923-1962 to about 10% in recent years.