. 2012 Apr 1;286(1):237–247. doi: 10.1007/s00404-012-2294-6

Table 4.

Second twin in non-cephalic presentation

Author	Year	Study design	Mode of delivery		Gestational age (weeks)	Presentation		Birth weight		5-min Apgar score <7		Neonatal mortality
Author	Year	Study design	VD/CS	N	Gestational age (weeks)	Twin A cephalic (%)	Twin B breech (%)	Twin A (g)	Twin B (g)	Twin A N (%)	Twin B N (%)	Twin A N (%)	Twin B N (%)
Differences in neonatal outcome
Atis [22]^a	2011	Retr cohort	VD	289	36 ± 6	100 %	NR	NR	2,335 ± 443	NR	44 (15 %)	NR	2 (1 %)
			CS	193	36 ± 6	100 %	NR	NR	2,558 ± 648	NR	16 (8 %)	NR	1 (1 %)
											p < 0.05		p > 0.05
No differences in neonatal outcome
Rabinovici [9]	1986	RCT	VD	33	38 ± 2	100 %	61 %	2,477 ± 370	2,459 ± 510	0	1 (3 %)	0	0
			CS	27	38 ± 2	100 %	67 %	2,533 ± 423	2484 ± 632	1 (4 %)	1 (4 %)	0	0
											p > 0.05
Wells [17]	1991	Retr cohort	VD-breech extraction	42	37	100 %	100 %	2,660	2,537	0	1 (2 %)	0	0
			VD-external version	11	35	100 %	100 %	2,363	2,389	0	0	0	0
			CS	29	37	100 %	100 %	2,701	2,521	0	0	0	0
										p > 0.05	p > 0.05
Gocke [18]	1989	Retr cohort	VD-breech extraction	55	37	100 %	100 %	2,544	2,569	0	1 (3 %)	0	0
			VD-exernal version	41	36	100 %	100 %	2,399	2,365	0	0	0	0
			CS	40	36	100 %	100 %	2,356	2,347	0	0	0	0
											p > 0.05
Caukwell [19]^a	2002	Retr cohort	VD	64	≥37	NR	NR	NR	NR	NR	4 (6 %)	NR	0
			CS	34	≥37	NR	NR	NR	NR	NR	3 (9 %)	NR	0
											p > 0.05
Winn [20]^b	2001	Retr cohort	VD	31	34 ± 2	NR	100 %	NR	2,115 ± 415	NR	NR	0	0
			CS-without labour	34	35 ± 2	NR	100 %	NR	2,242 ± 456	NR	NR	0	0
			CS-with labour	36	34 ± 2	NR	100 %	NR	2,215 ± 442	NR	NR	0	0
											p > 0.05
Acker [21]^c	1981	Retr cohort	VD	76	NR	NR	100 %	>1,500	>1,500	NR	11 (15 %)	0	0
			CS	75	NR	NR	NR	>1,500	>1,500	NR	7 (10 %)	0	0
											p > 0.05
Roopnarinesingh [24]	2002	Retr cohort	VD	54	>32	NR	100 %	NR	1,560–2,960	NR	0	NR	0
			CS	33	>32	NR	100 %	NR	1,220–3,040	NR	0	NR	1 (3 %)
Mauldin [26]^a	1998	Prosp cohort	VD-breech extraction	41	35 ± 4	NR	NR	2,270 ± 741	2,167 ± 728	14	17	NR	NR
			VD-external version	19	34 ± 2	NR	NR	2,233 ± 561	2,295 ± 702	0	10	NR	NR
			CS	24	35 ± 4	NR	NR	2,169 ± 680	2,116 ± 739	16	20	NR	NR
										p > 0.05	p > 0.05
Kelsick [27]	1982	Retr cohort	VD	590	NR	NR	100 %	2,000–4,000	2,000–4,000	NR	NR	NR	1 (0.2 %)
			CS	141	NR	NR	100 %	2,000–4,000	2,000–4000	NR	NR	NR	1 (0.2 %)
													p > 0.05
Greig [28]^a,d	1992	Retr cohort	VD	12	NR	NR	NR	NR	1,500–1,999	NR	NR	NR	NR
		(1,500–1,999 g)	CS	24	NR	NR	NR	NR	1,500–1,999	NR	NR	NR	NR
											p > 0.05
		Retr cohort	VD	21	NR	NR	NR	NR	1,500–1,999	NR	NR	NR	NR
		(2,000–2,499 g)	CS	31	NR	NR	NR	NR	1,500–1,999	NR	NR	NR	NR
											p > 0.05
		Retr cohort	VD	21	NR	NR	NR	NR	1,500–1,999	NR	NR	NR	NR
		(≥2,500 g)	CS	46	NR	NR	NR	NR	1,500–1,999	NR	NR	NR	NR
											p > 0.05

Significant differences were defined according to the definitions and statistics used in the different studies

VD Vaginal delivery, CS Caesarean section, N Number of twin pairs, RCT Randomized controlled trial, Retr Retrospective, Prosp Prospective, NR Not reported

^aAtis [22], Caukwell [19], Mauldin [26], Greig [28]: twin B in non-cephalic postition, not further specified to breech or transverse position

^bWinn [20] did not report the percentage of 5-min Apgar scores <7, but did report the mean 5-min Apgar scores: 8 ± 1 in VD and CS-with labour group, and 9 ± 1 in the CS-without labour group (without significant differences)

^cAcker [21]: twins delivered by caesarean section: twin A or B was in non-cephalic presentation

^dGreig [28] did not report the percentage of 5-min Apgar scores <7, but did report the mean 5-min Apgar scores: 1,500–1,999 g and 2,000–2,499 g: 9 in the VD and 8 in the CS group (without significant differences); ≥2,500 g: 9 in the VD group and 9 in the CS group (without significant differences)