RCOG World Congress 2025

Twin vaginal delivery; a review of trends and clinical outcomes

Objective

Provide up to date local data on success of vaginal delivery when birthing a twin pregnancy.

Method

Retrospective review review of all deliveries of twin pregnancies after 24 weeks 0 days gestation at Liverpool Women’s Hospital between January 2020 and October 2024 using electronic case notes.

Results

590 cases reviewed

- 288 (48.8%) patients had an elective caesarean section, either obstetrically indicated or maternal request,11 of these were preformed after the start of spontaneous labour. 9 of these were MCMA twin pregnancies

- 100 (16.9%) required an emergency caesarean section (EMCS) before the onset of labour.

- 191. 64 primipara and 127 multipara women aimed for vaginal delivery (VD) following spontaneous onset of labour or induction of labour.

Discussion

-Overall rate of successful VD is high 77.5%, as expected this is higher in Multiparus women

-Assisted vaginal birth rate is higher than singleton births

-Use of an epidural increases rate of assisted birth, particularly in multiparus women

-EMCS of twin 2 is higher in multiparuswomen. In primipara is it is lower than the often quoted 5%

-Twin 2 will most likely remain in their initial presentation, highlighting the effect of good stabilising after the birth of Twin 1

Conclusion

These results provide the most up-to-date data for our local population, supporting the recommendation of attempting a vaginal twin delivery when possible. This empowers women to make informed, evidence-based decisions regarding the birth of their babies.

RCOG World Congress 2025

Twin vaginal delivery; a review of trends and clinical outcomes.

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